A Prospective Study on the Incidence and Clinical Relevance of Heparin-Induced Antibodies in Patients after Vascular Surgery

Lindhoff-Last, Edelgard; Eichler, Petra; Stein, Martina; Plagemann, Judith; Gerdsen, Frank; Wagner, Richard; Ehrly, Albert M.; Bauersachs, Rupert

doi:10.1016/s0049-3848(99)00198-x

Cited by 65 publications

(51 citation statements)

References 16 publications

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“…A prospective study should also elucidate the frequency and relevance of HPF4 antibodies in pediatric patients after cardiac surgery, a controversial issue in adult patients. 8,26,27 We conclude that physicians caring for children should be aware of HIT-associated thrombosis as a severe side effect of heparin administration. Critically ill newborns and children represent a high-risk group.…”

Section: Discussionmentioning

confidence: 90%

Heparin-Induced Thrombocytopenia-Associated Thrombosis in Pediatric Intensive Care Patients

et al. 2002

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Section: Discussionmentioning

confidence: 90%

Heparin-Induced Thrombocytopenia-Associated Thrombosis in Pediatric Intensive Care Patients

et al. 2002

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“…The incidence of anti-heparin-platelet factor 4 antibodies induced by heparin in patients with normal renal function varied from 2.7% to 34% in various clinical settings (8,9). Because heparin is used in almost all hemodialysis patients, the prevalence of these heparin-dependent antibodies might be higher in patients on hemodialysis than in the general population who have never used heparin.…”

Section: Discussionmentioning

confidence: 99%

“…Our study showed that there was a higher prevalence of anti-heparin-platelet factor 4 antibodies in hemodialysis patients and this supports that heparin can induce formation of these heparin-dependent antibodies. The frequency of anti-heparin-platelet factor 4 antibody formation increased progressively with the duration of heparin treatment (9). Recent reports have shown that during prolonged heparin treatment 30-60% of patients with nor-HD, hemodialysis; VAO, vascular access obstruction; BP, blood pressure; PAI-1, plasminogen activator inhibitor-1; t-PA, tissue plasminogen activator.…”

Section: Discussionmentioning

confidence: 99%

Anti-Heparin-Platelet Factor 4 Antibody is a Risk Factor for Vascular Access Obstruction in Patients Undergoing Hemodialysis

et al. 2003

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Since heparin is an anticoagulant commonly used in hemodialysis and the patients on hemodialysis are repeatedly exposed to heparin, heparin may be the cause of the development of heparin-dependent antibodies and thrombotic complications in patients on hemodialysis. The purpose of this study was to determine the prevalence and the clinical significance of the antibodies against heparin-platelet factor 4 complexes as determined by enzyme immunoassay in patients on maintenance hemodialysis. The prevalence of anti-heparin-platelet factor 4 antibodies was higher in hemodialysis patients than in normal subjects (8.8 vs 0.0%, p<0.05). The number of past episodes of vascular access obstruction per year was significantly higher in the anti-heparin-platelet factor 4 antibody positive group than antibody negative group. Anti-heparin-platelet factor 4 antibody positive patients experienced more frequent vascular access obstructions than control subjects. In conclusion, anti-heparin-platelet factor 4 antibody might be a risk factor for vascular access obstructions in patients with end-stage renal disease on maintenance hemodialysis.

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“…In regard to disease specific impacts on HIT, comprehensive and reliable data mainly exist based on patient series from cardiac surgery [17] , orthopedic surgery [18] , and vascular surgery [19,20] . However, reports and systematic studies on HIT in solid organ transplant recipients are rare and inconclusive.…”

Section: Introductionmentioning

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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A Prospective Study on the Incidence and Clinical Relevance of Heparin-Induced Antibodies in Patients after Vascular Surgery

Cited by 65 publications

References 16 publications

Heparin-Induced Thrombocytopenia-Associated Thrombosis in Pediatric Intensive Care Patients

Heparin-Induced Thrombocytopenia-Associated Thrombosis in Pediatric Intensive Care Patients

Anti-Heparin-Platelet Factor 4 Antibody is a Risk Factor for Vascular Access Obstruction in Patients Undergoing Hemodialysis

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

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