The study investigated the use of procoagulant factors during heart transplants in Virginia and their potential link to postoperative thrombosis. It found a decrease in the use of off-label recombinant activated factor VII (rFVIIa) but an increase in off-label prothrombin complex concentrate (PCC) use, with rFVIIa associated with a higher risk of thrombosis, although patients receiving it were more critically ill, which may have influenced the results.