HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Warkentin, T. E. Articles by Koster, A. Search for Related Content PubMed Articles by Warkentin, T. E. Articles by Koster, A. Related Collections Mechanical Circulatory Assistance

---

Reviews

Heparin-Induced Thrombocytopenia in Patients with Ventricular Assist Devices: Are New Prevention Strategies Required?

^a Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
^b Department of Immunology and Transfusion Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany
^c Department of Anesthesia, Deutsches Herzzentrum, Berlin, Germany

^_* Address correspondence to Dr Warkentin, Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 237 Barton St E, Rm 1-180A, Hamilton, Ontario, L8L2X2, Canada (Email: twarken{at}mcmaster.ca).

Heparin-induced thrombocytopenia (HIT) is caused by platelet-activating antiplatelet factor 4/heparin antibodies. However, clinical HIT (thrombocytopenia or thrombosis, or both) develops in only a minority of patients who form antibodies. It is difficult to distinguish HIT from non-HIT thrombocytopenia in patients after ventricular assist device (VAD) implantation. Further, the risks of heparin-induced immunization and clinical HIT approach 65% and 10%, respectively, in this patient population, with a particularly high risk of cerebrovascular ischemia/infarction. Given the apparent high risk of HIT and its complications, and the diagnostic challenges, we suggest that the VAD patient population be evaluated using alternative, nonheparin agents for routine postimplantation anticoagulation.