Lung transplantation using argatroban in severe heparin-induced thrombocytopenia during extracorporeal membrane oxygenation: a case series

Lung transplantation during heparin-induced thrombocytopenia (HIT) is controversial and often considered a contraindication because of the risk of increased bleeding and thrombosis in the recipient. Although lung transplantation offers the best chance for cure in end-stage lung disease, the outcome...

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2020-12, Vol.68 (12), p.1565-1568
Main Authors: Lee, Sung Kwang, Cho, Woo Hyun, Kim, Do Hyung, Yeo, Hye Ju
Format: Article
Language:English
Subjects:
Antibodies
Anticoagulants
Anticoagulants - adverse effects
Arginine - analogs & derivatives
Blood clots
Blood platelets
Cardiac Surgery
Cardiology
Case Report
Contraindications
Extracorporeal Membrane Oxygenation
Hematoma
Heparin - adverse effects
Humans
Lung Transplantation
Lung transplants
Medicine
Medicine & Public Health
Ostomy
Patients
Pipecolic Acids
Pulmonary arteries
Respiratory failure
Sulfonamides
Surgery
Surgical apparatus & instruments
Surgical Oncology
Thoracic Surgery
Thrombocytopenia
Thrombocytopenia - chemically induced
Thrombosis
Trends
Ventilation
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Summary:Lung transplantation during heparin-induced thrombocytopenia (HIT) is controversial and often considered a contraindication because of the risk of increased bleeding and thrombosis in the recipient. Although lung transplantation offers the best chance for cure in end-stage lung disease, the outcome after transplantation is still controversial in patients with HIT. In our center, two patients developed HIT type II during venovenous extracorporeal membrane oxygenation (ECMO) support for acute respiratory failure. They underwent successful lung transplantation using argatroban. The subsequent clinical course was uneventful except evacuation of post-operative hematoma in 1 patient, and they were discharged. Argatroban was successfully used during lung transplant surgery in patients who developed HIT type II during ECMO support. Further studies on the feasibility and safety of lung transplantation using a direct thrombin inhibitor in patients with HIT during ECMO are required
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-020-01356-9