Successful Use of Bivalirudin for Cardiac Transplantation in a Child With Heparin-induced Thrombocytopenia

Almond, Christopher S.; Harrington, James; Thiagarajan, Ravi R.; Duncan, Christine; LaPierre, Robert; Halwick, David R.; Blume, Elizabeth D.; Nido, Pedro J. del; Neufeld, Ellis J.; McGowan, Francis X.

doi:10.1016/j.healun.2006.08.005

Cited by 50 publications

(51 citation statements)

References 23 publications

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“…[10][11][12] Disadvantages include the lack of an available antidote, although it can be removed by dialysis or ultrafiltration after CPB, 14 and limited pediatric experience. 8,[13][14][15][16][17] The initial bivalirudin dose in our patients was based on estimates of the glomerular filtration rate as measured by the Schwartz formula and following suggestions by Warkentin et al 10 All patients had normal renal function, with the exception of Patient 2. Once therapeutic levels were achieved as determined by PTT, few dosage adjustments were required.…”

Section: Discussionmentioning

confidence: 99%

Antithrombotic strategies in children receiving long-term Berlin Heart EXCOR ventricular assist device therapy

Rutledge¹,

Chakravarti²,

Massicotte³

et al. 2013

The Journal of Heart and Lung Transplantation

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Section: Discussionmentioning

confidence: 99%

Antithrombotic strategies in children receiving long-term Berlin Heart EXCOR ventricular assist device therapy

Rutledge¹,

Chakravarti²,

Massicotte³

et al. 2013

The Journal of Heart and Lung Transplantation

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“…In addition to the 110 pediatric patients in this study, in published literature, 69 pediatric patients have received bivalirudin as an anticoagulant for percutaneous coronary interventions (n ¼ 33) and for the treatment or prevention of thrombosis (n ¼ 36) at a range of 1 day to 25 years of age [11][12][13][14][15][16][17]. The only prospective, pediatric dose-finding study was for a different indication (treatment of thrombosis) and using a different dosing regimen (no bolus and a lower continuous infusion) [18].…”

Section: Discussionmentioning

confidence: 99%

Pediatric catheterization laboratory anticoagulation with bivalirudin

Forbes

Hijazi

Young

et al. 2011

Cathet Cardio Intervent

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“…Respective considerations on HIT prevention have been published in several case reports [27][28][29][30][31][32][33][34][35] and are explicitly discussed in the guidelines published by both the American College of Physicians (ACCP) [12] and the British Society of Hematology [36] . In prospective studies a relevant discrepancy was observed between detection of anti-PF4/heparin antibodies (EIA positive: 27%-50% of the patients) and the capability of these antibodies to activate platelets (SRA or HIPA positive: 7%-40% within the EIA positive patients) [26,37,38] .…”

Section: Heart Transplantationmentioning

confidence: 99%

Heparin-induced thrombocytopenia in solid organ transplant recipients: The current scientific knowledge

Aßfalg

Hüser

2016

WJT

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Exposure to heparin is associated with a high incidence of immunization against platelet factor 4 (PF4)/heparin complexes. A subgroup of immunized patients is at risk of developing heparin-induced thrombocytopenia (HIT), an immune mediated prothrombotic adverse drug effect. Transplant recipients are frequently exposed to heparin either due to the underlying end-stage disease, which leads to listing and transplantation or during the transplant procedure and the perioperative period. To review the current scientific knowledge on antiheparin/PF4 antibodies and HIT in transplant recipients a systematic PubMed literature search on articles in English language was performed. The definition of HIT is inconsistent amongst the publications. Overall, six studies and 15 case reports have been published on HIT before or after heart, liver, kidney, and lung transplantation, respectively. The frequency of seroconversion for anti-PF4/heparin antibodies ranged between 1.9% and 57.9%. However, different methods to detect anti-PF4/heparin antibodies were applied. In none of the studies HIT-associated thromboembolic events or fatalities were observed. More importantly, in patients with a history of HIT, reexposure to heparin during transplantation was not associated with thrombotic complications. Taken together, the overall incidence of HIT after solid organ transplantation seems to be very low. However, according to the current knowledge, cardiac transplant recipients may have the highest risk to develop HIT. Different alternative suggestions for heparin-free anticoagulation have been reported for recipients with suspected HIT albeit no official recommendations on management have been published for this special collective so far. Core tip: Heparin-induced thrombocytopenia (HIT) Ⅱ is a life-threatening complication of heparin therapy. Transplant recipients frequently are exposed to high doses of heparin before, during, and after transplantation. This review gives a systematic overview MINIREVIEWS

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Successful Use of Bivalirudin for Cardiac Transplantation in a Child With Heparin-induced Thrombocytopenia

Cited by 50 publications

References 23 publications

Antithrombotic strategies in children receiving long-term Berlin Heart EXCOR ventricular assist device therapy

Antithrombotic strategies in children receiving long-term Berlin Heart EXCOR ventricular assist device therapy

Pediatric catheterization laboratory anticoagulation with bivalirudin

Heparin-induced thrombocytopenia in solid organ transplant recipients: The current scientific knowledge

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