PMID- 18791163
OWN - NLM
STAT- MEDLINE
DCOM- 20081125
LR  - 20210206
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Linking)
VI  - 112
IP  - 10
DP  - 2008 Nov 15
TI  - Management of anticoagulation in patients with subacute heparin-induced 
      thrombocytopenia scheduled for heart transplantation.
PG  - 4024-7
LID - 10.1182/blood-2008-03-145243 [doi]
AB  - Anticoagulation management of patients with recent heparin-induced 
      thrombocytopenia (HIT) requiring cardiopulmonary bypass (CPB) surgery is a 
      serious challenge, and especially difficult in patients requiring urgent heart 
      transplantation. As nonheparin anticoagulants during CPB bear a high risk of 
      major bleeding, these patients are at risk of being taken off the transplant 
      list. Short-term use of unfractionated heparin (UFH) for CPB, with restriction of 
      UFH to the surgery itself, is safe and effective in patients with a history of 
      HIT who test negative for antiplatelet factor 4 (PF4)/heparin antibodies. We 
      present evidence that it is safe to expand the concept of UFH reexposure to 
      patients with subacute HIT (ie, those patients with recent HIT in whom the 
      platelet count has recovered but in whom anti-PF4/heparin IgG antibodies remain 
      detectable) requiring heart transplantation, if they test negative by a sensitive 
      functional assay using washed platelets. This can be lifesaving in patients with 
      end-stage heart failure.
FAU - Selleng, Sixten
AU  - Selleng S
AD  - Institut fur Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt Universitat, 
      Greifswald, Germany.
FAU - Haneya, Assad
AU  - Haneya A
FAU - Hirt, Stephan
AU  - Hirt S
FAU - Selleng, Kathleen
AU  - Selleng K
FAU - Schmid, Christof
AU  - Schmid C
FAU - Greinacher, Andreas
AU  - Greinacher A
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20080912
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Anticoagulants)
RN  - 0 (Autoantibodies)
RN  - 0 (Hirudins)
RN  - 0 (Pipecolic Acids)
RN  - 0 (Recombinant Proteins)
RN  - 0 (Sulfonamides)
RN  - 37270-94-3 (Platelet Factor 4)
RN  - 9005-49-6 (Heparin)
RN  - 94ZLA3W45F (Arginine)
RN  - IY90U61Z3S (argatroban)
RN  - Y43GF64R34 (lepirudin)
SB  - IM
MH  - Adult
MH  - Anticoagulants/*administration & dosage/*adverse effects
MH  - Arginine/analogs & derivatives
MH  - Autoantibodies/blood/immunology
MH  - Heart Failure/blood/immunology/*surgery
MH  - *Heart Transplantation/immunology
MH  - Heparin/*administration & dosage/*adverse effects/immunology
MH  - Hirudins/administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pipecolic Acids/administration & dosage
MH  - Platelet Factor 4/immunology
MH  - Recombinant Proteins/administration & dosage
MH  - Sulfonamides
MH  - Thrombocytopenia/*blood/*chemically induced/immunology
EDAT- 2008/09/16 09:00
MHDA- 2008/12/17 09:00
CRDT- 2008/09/16 09:00
PHST- 2008/09/16 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/09/16 09:00 [entrez]
AID - S0006-4971(20)51855-7 [pii]
AID - 10.1182/blood-2008-03-145243 [doi]
PST - ppublish
SO  - Blood. 2008 Nov 15;112(10):4024-7. doi: 10.1182/blood-2008-03-145243. Epub 2008 
      Sep 12.