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

Publication ,  Journal Article
Moreno-Duarte, I; Cooter, M; Onwuemene, OA; Ghadimi, K; Welsby, IJ
Published in: Vox Sang
February 2021

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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Published In

Vox Sang

DOI

EISSN

1423-0410

Publication Date

February 2021

Volume

116

Issue

2

Start / End Page

217 / 224

Location

England

Related Subject Headings

  • Treatment Outcome
  • Thrombosis
  • Thromboembolism
  • Thrombocytopenia
  • Plasma Exchange
  • Perioperative Period
  • Middle Aged
  • Male
  • Humans
  • Heparin
 

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Moreno-Duarte, I., Cooter, M., Onwuemene, O. A., Ghadimi, K., & Welsby, I. J. (2021). Clinical outcomes of cardiac surgery patients undergoing therapeutic plasma exchange for heparin-induced thrombocytopenia. Vox Sang, 116(2), 217–224. https://doi.org/10.1111/vox.13008
Moreno-Duarte, Ingrid, Mary Cooter, Oluwatoyosi A. Onwuemene, Kamrouz Ghadimi, and Ian J. Welsby. “Clinical outcomes of cardiac surgery patients undergoing therapeutic plasma exchange for heparin-induced thrombocytopenia.Vox Sang 116, no. 2 (February 2021): 217–24. https://doi.org/10.1111/vox.13008.
Moreno-Duarte I, Cooter M, Onwuemene OA, Ghadimi K, Welsby IJ. Clinical outcomes of cardiac surgery patients undergoing therapeutic plasma exchange for heparin-induced thrombocytopenia. Vox Sang. 2021 Feb;116(2):217–24.
Moreno-Duarte, Ingrid, et al. “Clinical outcomes of cardiac surgery patients undergoing therapeutic plasma exchange for heparin-induced thrombocytopenia.Vox Sang, vol. 116, no. 2, Feb. 2021, pp. 217–24. Pubmed, doi:10.1111/vox.13008.
Moreno-Duarte I, Cooter M, Onwuemene OA, Ghadimi K, Welsby IJ. Clinical outcomes of cardiac surgery patients undergoing therapeutic plasma exchange for heparin-induced thrombocytopenia. Vox Sang. 2021 Feb;116(2):217–224.
Journal cover image

Published In

Vox Sang

DOI

EISSN

1423-0410

Publication Date

February 2021

Volume

116

Issue

2

Start / End Page

217 / 224

Location

England

Related Subject Headings

  • Treatment Outcome
  • Thrombosis
  • Thromboembolism
  • Thrombocytopenia
  • Plasma Exchange
  • Perioperative Period
  • Middle Aged
  • Male
  • Humans
  • Heparin