PMID- 34927287
OWN - NLM
STAT- MEDLINE
DCOM- 20220425
LR  - 20220425
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 36
IP  - 2
DP  - 2022 Feb
TI  - Cardiac transplantation after heparin-induced thrombocytopenia: A systematic 
      review.
PG  - e14567
LID - 10.1111/ctr.14567 [doi]
AB  - PURPOSE: Heparin-induced thrombocytopenia (HIT) presents a unique challenge in 
      patients requiring orthotopic heart transplantation (OHT). We sought to pool the 
      existing evidence in a systematic review. METHODS: Electronic search was 
      performed to identify all relevant studies on OHT in patients with HIT. 
      Patient-level data for 33 patients from 21 studies were extracted for statistical 
      analysis. RESULTS: Median patient age was 51 [IQR 41, 55] years, with 75.8% 
      (25/33) males. All patients had a clinical diagnosis of HIT, and anti-PF4/Heparin 
      antibodies were positive in 87.9% (29/33). Median lowest reported platelet count 
      was 46 x 10(9) /L [27.2, 73.5]. Intraoperatively, 61% (20/33) of patients were 
      given unfractionated heparin (UFH), while 39% (13/33) were given alternative 
      anticoagulants. The alternative agent subgroup required more antifibrinolytics 
      [54% (7/13) vs 10% (2/20), P = .02] and clotting factors [69.2% (9/13) vs 15.0% 
      (3/20), P < .01]. Perioperative thrombosis occurred more [53.8% (7/13) vs 0% 
      (0/20, P < .01) in alternate agent subgroup. More patients in the alternate agent 
      subgroup required post-operative transfusions [54% (7/13) vs 0% (0/20), P < .01]. 
      Thirty-day mortality of 15.2% (5/33) was comparable between the subgroups. 
      CONCLUSION: Heparin use during OHT may be associated with less adverse effects 
      compared to use of other anticoagulants with no difference in 30-day mortality.
CI  - (c) 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Jimenez, Diana C
AU  - Jimenez DC
AD  - Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, 
      Pennsylvania, USA.
FAU - Warner, Eric D
AU  - Warner ED
AD  - Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, 
      Pennsylvania, USA.
FAU - Ahmad, Danial
AU  - Ahmad D
AUID- ORCID: 0000-0001-8141-945X
AD  - Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, 
      Pennsylvania, USA.
FAU - Rosen, Jake L
AU  - Rosen JL
AD  - Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, 
      Pennsylvania, USA.
FAU - Al-Rawas, Nawar
AU  - Al-Rawas N
AD  - Department of Anesthesiology, Thomas Jefferson University, Philadelphia, 
      Pennsylvania, USA.
FAU - Morris, Rohinton J
AU  - Morris RJ
AD  - Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, 
      Pennsylvania, USA.
FAU - Alvarez, Rene
AU  - Alvarez R
AD  - Division of Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, 
      USA.
FAU - Rame, J Eduardo
AU  - Rame JE
AD  - Division of Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, 
      USA.
FAU - Entwistle, John W
AU  - Entwistle JW
AD  - Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, 
      Pennsylvania, USA.
FAU - Massey, H Todd
AU  - Massey HT
AD  - Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, 
      Pennsylvania, USA.
FAU - Tchantchaleishvili, Vakhtang
AU  - Tchantchaleishvili V
AD  - Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, 
      Pennsylvania, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20220106
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/adverse effects
MH  - *Heart Transplantation
MH  - Heparin/adverse effects
MH  - Humans
MH  - Male
MH  - *Thrombocytopenia/chemically induced
MH  - *Thrombosis
OTO - NOTNLM
OT  - cardiovascular disease, coagulation and hemostasis, complication, heart 
      (allograft) function
OT  - dysfunction, thrombosis and thromboembolism
EDAT- 2021/12/21 06:00
MHDA- 2022/04/26 06:00
CRDT- 2021/12/20 06:36
PHST- 2021/12/10 00:00 [revised]
PHST- 2021/09/14 00:00 [received]
PHST- 2021/12/14 00:00 [accepted]
PHST- 2021/12/21 06:00 [pubmed]
PHST- 2022/04/26 06:00 [medline]
PHST- 2021/12/20 06:36 [entrez]
AID - 10.1111/ctr.14567 [doi]
PST - ppublish
SO  - Clin Transplant. 2022 Feb;36(2):e14567. doi: 10.1111/ctr.14567. Epub 2022 Jan 6.