title: The "white clot syndrome" in hepatic transplantation.
abstract: Heparin-associated thrombocytopenia and thrombosis (Type II HAT), the "white clot syndrome," has not been previously reported as a cause for fulminant hepatic failure after liver transplantation. Thrombocytopenia and the use of heparin are common events in the newly transplanted patient. A man who was transplanted for sclerosing cholangitis, and re-exposed to heparin, is described with thrombocytopenia, thrombosis of all hepatic vessels, and heparin antibodies. Type II HAT is an immune phenomenon that can apparently occur despite T-cell-directed immunosuppression. Suspicion is a key element in establishing diagnosis. We no longer use heparin routinely in liver transplant cases.
authors.affiliation: University of Texas Medical Branch, Galveston 77555-0538, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Broughan
authors.forename: K
authors.initials: K
authors.lastname: Kottke-Marchant
authors.forename: D P
authors.initials: DP
authors.lastname: Vogt
mesh_terms: D006493:Heparin / Q000009:adverse effects; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced / Q000209:etiology*; D013927:Thrombosis / Q000139:chemically induced / Q000209:etiology*
chemical_list: D006493:Heparin