Comparison of bovine and porcine heparin in heparin antibody formation after cardiac surgery

Francis, John L.; Palmer, George J.; Moroose, Rebecca; Drexler, Alane

doi:10.1016/s0003-4975(02)04349-7

Cited by 145 publications

(85 citation statements)

References 24 publications

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“…HIT occurs after the fifth day of the heparin start, however, in patients with previous use it may occur on the first day [28], furthermore, a small dose of heparin can cause immune sensitization to subsequent exposure to heparin. [29] The type of unfractionated heparin (bovine) used in this study is a limitation [30], since it has been associated with higher incidence of antibodies against the heparinplatelet factor 4 complex [31].…”

Section: Discussionmentioning

confidence: 99%

Trombocitopenia em cirurgia cardíaca: importância diagnóstica e prognóstica

Rezende¹,

Morais²,

Silva³

et al. 2011

Rev Bras Cir Cardiovasc

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Section: Discussionmentioning

confidence: 99%

Trombocitopenia em cirurgia cardíaca: importância diagnóstica e prognóstica

Rezende¹,

Morais²,

Silva³

et al. 2011

Rev Bras Cir Cardiovasc

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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] . The development of clinically relevant HITTS was reported to range between 1% and 3% [39] and is therefore considerably smaller in regards to the high rate of seroconversion.…”

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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“…Interestingly, the rate of false positive results (defined as positive serology in the absence of thrombocytopenia and other clinical criteria for the diagnosis of HIT) varies depending on the patient population. For example, in postcardiac surgery patients, the false positive rate can be as high as 50-60% [26][27][28][29][30]. As a result, positive tests are more challenging to interpret than negative tests.…”

Section: Laboratory Detection Of Hit Antibodiesmentioning

confidence: 99%

Heparin‐induced thrombocytopenia: Current status and diagnostic challenges

Otis

Zehnder

2010

American J Hematol

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Heparin‐induced thrombocytopenia (HIT) is a fairly common and potentially catastrophic complication of heparin therapy. Diagnosing HIT remains a challenge, as the patients at risk often have other reasons for thrombocytopenia and/or thrombosis. HIT is considered a clinicopathologic disorder whose diagnosis is generally made on the basis of both clinical criteria and the presence of “HIT antibodies” in the patient's serum or plasma. There are two basic laboratory approaches to detect HIT antibodies. The immunoassays detect antibodies based on their binding properties, whereas the functional assays detect antibodies based on their platelet‐activating properties. Prompt and accurate diagnosis of HIT is imperative, as overdiagnosis exposes patients to alternative anticoagulants and their associated bleeding risks, whereas under‐ or delayed diagnosis leaves patients vulnerable to the thromboembolic sequelae of HIT, which can be life threatening. A critical interpretation of laboratory results by the clinician is an essential component of diagnosing HIT. This requires a keen understanding of the current concepts in the pathophysiologic mechanisms of the disease, and the application of these concepts when interpreting the results of both the functional and immunoassays. Equally important is an awareness of the strengths and weaknesses, as well as the current lack of standardization and proficiency testing, of these assays. Am. J. Hematol., 2010. © 2010 Wiley‐Liss, Inc.

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Comparison of bovine and porcine heparin in heparin antibody formation after cardiac surgery

Cited by 145 publications

References 24 publications

Trombocitopenia em cirurgia cardíaca: importância diagnóstica e prognóstica

Trombocitopenia em cirurgia cardíaca: importância diagnóstica e prognóstica

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

Heparin‐induced thrombocytopenia: Current status and diagnostic challenges

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