Literature review of apheresis procedures performed perioperatively in cardiac surgery for ASFA category indications

Kanellopoulou, Theoni; Kostelidou, Theodora

doi:10.1002/jca.21676

Cited by 3 publications

(3 citation statements)

References 32 publications

(92 reference statements)

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“…Крім того, при проведенні будь-яких екстракорпоральних процедур спостерігається зниження числа тромбоцитів, що є ще одним фактором ризику розвитку кровотечі [12][13][14]. Проте вважається, що плазмообмін до, під час та після хірургічних втручань є ефективною і безпечною процедурою [15,16].…”

Section: основні методи елімінації анти-A/b антитілunclassified

Методы Диагностики И Элиминации Анти-А/В Антител При АВ0 Несовместимой Трансплантации Почки

Malik¹,

Zohrabian²

2021

KIDNEYS

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Трансплантація АВ0-несумісного органа може призвести до опосередкованого анти-А/В антитілами надгострого або гострого відторгнення. Важливим фактором виживання трансплантата за таких умов стає ефективне видалення цих антитіл (особливо ІgG) з кровообігу реципієнта [1, 2]. Точне визначення титру групових антитіл системи АВ0 у реципієнта дозволяє підібрати схему його підготовки до АВ0-несумісної трансплантації [3-6]. Антитіла системи АВ0 α і β є нормальними (природними) у людини. Вони належать до повних антитіл-аглютинінів, які добре реагують у сольовому середовищі. Існує метод, рекомендований наказом МОЗ України № 164 від 05.07.1999 р., визначення повних імунних антитіл системи АВ0 за допомогою реакції со

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“…Intraoperative TPE is a valuable adjunct in the management of antibody-mediated syndromes including HIT and is FDA-approved for the treatment of thrombotic thrombocytopenic purpura. TPE permits heparin use by removing immune complexes and HIT antibodies [113]. Intraoperative TPE can also allow for the routine reversal of post-cardiopulmonary bypass heparin reversal using protamine.…”

Section: Patients Requiring Surgical Procedures With Heparinizationmentioning

confidence: 99%

Heparin Induced Thrombocytopenia for the Perioperative and Critical Care Clinician

Moreno-Duarte

Ghadimi

2020

Curr Anesthesiol Rep

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Purpose of Review This review will illustrate the importance of heparin-induced thrombocytopenia in the intraoperative and critical care settings. Recent Findings Heparin-induced thrombocytopenia (HIT) occurs more frequently in surgical patients compared with medical patients due to the inflammatory release of platelet factor 4 and perioperative heparin exposure. Recognition of this disease requires a high index of suspicion. Diagnostic tools and therapeutic strategies have been expanded and refined in recent years. Summary HIT is a condition where antibodies against the heparin/platelet factor 4 complex interact with platelet receptors to promote platelet activation, aggregation, and thrombus formation. Our review will focus on intraoperative and postoperative considerations related to HIT to help the clinician better manage this rare but often devastating hypercoagulable disease process.

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“…Intraoperative therapeutic plasma exchange (TPE) is a valuable adjunct in the management of antibody‐mediated syndromes including HIT. TPE permits heparin use by removing immune complexes and HIT antibodies [5]. Intraoperative TPE allows the use of heparin rather than irreversible heparin alternatives.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of cardiac surgery patients undergoing therapeutic plasma exchange for heparin‐induced thrombocytopenia

et al. 2020

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Background and Objectives Heparin‐induced thrombocytopenia (HIT) is an antibody‐mediated condition that leads to thrombocytopenia and possible thrombosis. Patients with HIT who require cardiac surgery pose a challenge as high doses of heparin or heparin alternatives are required to permit cardiopulmonary bypass (CPB). Intraoperative therapeutic plasma exchange (TPE) is a valuable adjunct in the management of antibody‐mediated syndromes including HIT. The clinical impact of TPE on thromboembolic events, bleeding and mortality after heparin re‐exposure is not well established. We hypothesized that TPE with heparin re‐exposure will not lead to HIT‐related thromboembolic events, bleeding or increased mortality after cardiac surgery with CPB. Materials and Methods We reviewed 330 patients who received perioperative TPE between September 2012 and September 2017. Results Twenty four patients received TPE for HIT before anticipated heparin use for CPB. Most patients were males (79%) scheduled for advanced heart failure therapies. Three patients (12·5%) died within 30 days after surgery but none of the deaths were considered HIT‐related. Thromboembolic events (TE) occurred in 3 patients within 7 days of surgery; of those, two were possibly HIT‐related. Conclusion Therapeutic plasma exchange with heparin re‐exposure was not strongly associated with HIT‐related thrombosis/death after cardiac surgery with CPB.

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Literature review of apheresis procedures performed perioperatively in cardiac surgery for ASFA category indications

Cited by 3 publications

References 32 publications

Методы Диагностики И Элиминации Анти-А/В Антител При АВ0 Несовместимой Трансплантации Почки

Heparin Induced Thrombocytopenia for the Perioperative and Critical Care Clinician

Clinical outcomes of cardiac surgery patients undergoing therapeutic plasma exchange for heparin‐induced thrombocytopenia

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