Immobilization and high platelet count are associated with thromboembolic complications in heparin-induced thrombocytopenia

Bolbrinker, Juliane; Garbe, Edeltraut; Douros, Antonios; Huber, Matthias; Bronder, Elisabeth; Klimpel, Andreas; Andersohn, Frank; Meyer, Oliver; Salama, Abdulgabar; Kreutz, Reinhold

doi:10.1002/pds.4235

Cited by 3 publications

(3 citation statements)

References 41 publications

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“…Chronic allograft dysfunction was the most common cause of death for recipients with HIT, similar to lung transplant recipients overall who survive more than 1 year. 20 Despite the fact that patients who develop HIT have a very high 30-day incidence of arterial thromboembolic event and VTE as well as thrombosis-related death, 17,21 we did not observe any significant difference in terms of mortality between lung transplant recipients who developed HIT and those who did not. We believe that early recognition and prompt management was of paramount importance to mitigate the risk of extensive and/or life-threatening thromboembolic events.…”

Section: Discussionmentioning

confidence: 53%

“…Arterial thromboembolic event and VTE are common in HIT, with retrospective and prospective cohorts reporting an incidence of objectively confirmed thromboembolic events in 20% to 34% of patients within 30 days of HIT diagnosis. 3,[15][16][17] Without treatment, the rate of thrombosis was estimated at 5% per day without alternative anticoagulation with a direct thrombin inhibitor. 18 In our study, we found an incidence of VTE of 72%, higher compared to other reports, but no patients had arterial thromboembolism.…”

Section: Discussionmentioning

confidence: 99%

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A Novel Diagnostic Algorithm for Heparin-Induced Thrombocytopenia in a Retrospective Cohort of Lung Transplant Recipients

et al. 2019

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Introduction: Heparin-induced thrombocytopenia (HIT) is characterized by thrombocytopenia and potential for thromboembolism. Lung transplant recipients are at risk of developing HIT due to heparin exposure peritransplant. We describe the incidence and impact of HIT in lung transplant recipient index hospital length of stay and survival. Design: A retrospective cohort was obtained from electronic medical records which were queried for all recipients treated with bivalirudin (institutional treatment of choice for HIT) between January 1, 2005, and February 16, 2017 (N = 1171). Patients who developed HIT >30 days after transplant or after their index transplant admission were excluded. A diagnostic algorithm was used retrospectively to determine clinical HIT with an intermediate or high pretest clinical suspicion (“4T” score ≥4) and either (1) positive anti-heparin–platelet-factor 4 (HPF4) assay and a positive functional platelet assay or (2) a positive HPF4 assay only, in patients who did not undergo cardiopulmonary bypass. Results: Among all lung transplant recipients, 2.1% were found to develop HIT in the peritransplant period (N = 25, mean = 88%) with a mean lung allocation score of 50.8 and an incidence of venous thromboembolism of 72%, most upper extremity in location. When matched with historical controls, patients with HIT had a longer overall index hospital length of stay of 43 days ( P = .008). There was no difference in short- or long-term survival posttransplant. Conclusion: Vigilance for the development of HIT in lung transplant recipients is necessary to prevent further morbidity from thromboembolic events. In our cohort, HIT increased hospital length of stay but did not appear to affect recipient survival.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

A Novel Diagnostic Algorithm for Heparin-Induced Thrombocytopenia in a Retrospective Cohort of Lung Transplant Recipients

et al. 2019

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“…Heparin is called glycosaminoglycans which is widely used as therapeutic agents in biomedical fields due to its lots of crucial biological functions since its discovery in 1916. − To date, it has been extensively used in clinical practice especially for the prevention and treatment of deep vein thrombosis, arterial thromboembolism, and pulmonary embolism. − Thrombus is a blood coagulant made up of fibrin. Once the thrombus is formed in the blood vessel, it can become more and more tightened as time goes by, and the attachment to the blood vessel wall is also more and more solid.…”

Section: Introductionmentioning

confidence: 99%

Preparation and Properties of Janus Heparin-Loaded Ammoniated-Hollow Mesoporous Silica Nanomotors

Shao

Chen

et al. 2018

J. Phys. Chem. C

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In this case, the development of Janus heparinloaded ammoniated-hollow mesoporous silica (H-A-HMS) nanomotors was reported. First, A-HMS nanoparticles were prepared by combination of hard template (Fe 3 O 4 regarded as core), soft template (cetyltrimethylammonium bromide (CTAB) regarded as mesoporous template agent) and ammoniated process. Then, the heparin was loaded into A-HMS nanoparticles by a simple soaking process, and Janus H-A-HMS nanomotors were fabricated by platinum (Pt) decorating onto the partial surface of H-A-HMS nanoparticles, which the bubble-propelled motion was obtain by the help of Pt catalytic decomposition of hydrogen peroxide (H 2 O 2 ) into oxygen (gas) and water. Finally, results of a performance test indicated that the H-A-HMS nanomotors we proposed had good blood compatibility, noncytotoxicity, high load and controlled release of heparin, and autonomous motion ability. They will bring great potential for more applications of heparin in the biomedical field.

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Targeted resequencing of a locus for heparin-induced thrombocytopenia on chromosome 5 identified in a genome-wide association study

et al. 2018

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Immobilization and high platelet count are associated with thromboembolic complications in heparin-induced thrombocytopenia

Abstract: Immobilization and a high platelet count (with a low effect size) are additional risk factors of thromboembolic complications in the course of HIT.

Cited by 3 publications

References 41 publications

A Novel Diagnostic Algorithm for Heparin-Induced Thrombocytopenia in a Retrospective Cohort of Lung Transplant Recipients

A Novel Diagnostic Algorithm for Heparin-Induced Thrombocytopenia in a Retrospective Cohort of Lung Transplant Recipients

Preparation and Properties of Janus Heparin-Loaded Ammoniated-Hollow Mesoporous Silica Nanomotors

Targeted resequencing of a locus for heparin-induced thrombocytopenia on chromosome 5 identified in a genome-wide association study

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