PMID- 38304955
OWN - NLM
STAT- MEDLINE
DCOM- 20240313
LR  - 20240313
IS  - 1875-9114 (Electronic)
IS  - 0277-0008 (Linking)
VI  - 44
IP  - 3
DP  - 2024 Mar
TI  - Use of bivalirudin after initial heparin management among adult patients on 
      long-term venovenous extracorporeal support as a bridge to lung transplant: A 
      case series.
PG  - 283-289
LID - 10.1002/phar.2910 [doi]
AB  - A growing body of evidence supports the use of bivalirudin as an alternative to 
      unfractionated heparin (UFH) for the prevention of thrombotic events in patients 
      on venovenous (VV) extracorporeal membrane oxygenation (ECMO). However, data in 
      patients bridged to lung transplantation are limited. In this case series, we 
      describe the outcomes of six patients who were transitioned from UFH to 
      bivalirudin during their course of VV ECMO support as a bridge to lung 
      transplantation. All six patients were on VV ECMO support until transplant, with 
      a median duration of 73 days. Bivalirudin demonstrated a shorter time to first 
      therapeutic activated thromboplastin time (aPTT) level. Additionally, time in 
      therapeutic range was longer while patients were receiving bivalirudin compared 
      to UFH (median 92.9% vs. 74.6%). However, major bleeding and thrombotic events 
      occurred while patients were receiving either anticoagulant. Based on our 
      experience, bivalirudin appears to be a viable option for anticoagulation in VV 
      ECMO patients bridged to lung transplantation. Larger studies evaluating the 
      optimal anticoagulation strategy in patients bridged to transplant are needed.
CI  - (c) 2024 Pharmacotherapy Publications, Inc.
FAU - Halawi, Hala
AU  - Halawi H
AUID- ORCID: 0000-0002-3969-5634
AD  - Department of Pharmacy, Houston Methodist Hospital, Houston, Texas, USA.
FAU - Harris, Jesse E
AU  - Harris JE
AD  - Department of Pharmacy, Houston Methodist Hospital, Houston, Texas, USA.
FAU - Goodarzi, Ahmad
AU  - Goodarzi A
AD  - Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.
AD  - J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas, 
      USA.
FAU - Yau, Simon
AU  - Yau S
AD  - Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.
AD  - J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas, 
      USA.
FAU - Youssef, Jihad G
AU  - Youssef JG
AD  - Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.
AD  - J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas, 
      USA.
FAU - Botros, Mena
AU  - Botros M
AUID- ORCID: 0000-0003-4809-6657
AD  - Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.
AD  - J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas, 
      USA.
FAU - Huang, Howard J
AU  - Huang HJ
AD  - Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.
AD  - J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas, 
      USA.
LA  - eng
PT  - Case Reports
DEP - 20240202
PL  - United States
TA  - Pharmacotherapy
JT  - Pharmacotherapy
JID - 8111305
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
RN  - 0 (Anticoagulants)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Heparin/adverse effects
MH  - Retrospective Studies
MH  - Anticoagulants/adverse effects
MH  - Hirudins/adverse effects
MH  - Peptide Fragments/therapeutic use
MH  - *Thrombosis/etiology/prevention & control
MH  - *Lung Transplantation
MH  - Recombinant Proteins/therapeutic use
OTO - NOTNLM
OT  - ECMO
OT  - anticoagulation
OT  - bivalirudin
OT  - lung transplant
EDAT- 2024/02/02 06:43
MHDA- 2024/03/13 06:47
CRDT- 2024/02/02 04:19
PHST- 2023/12/16 00:00 [revised]
PHST- 2023/09/03 00:00 [received]
PHST- 2023/12/22 00:00 [accepted]
PHST- 2024/03/13 06:47 [medline]
PHST- 2024/02/02 06:43 [pubmed]
PHST- 2024/02/02 04:19 [entrez]
AID - 10.1002/phar.2910 [doi]
PST - ppublish
SO  - Pharmacotherapy. 2024 Mar;44(3):283-289. doi: 10.1002/phar.2910. Epub 2024 Feb 2.