title: Frequency of anti-heparin-platelet factor 4 antibodies in hemodialysis patients and correlation with recurrent vascular access thrombosis.
abstract: Heparin-induced thrombocytopenia (HIT), characterized by the formation of antibodies to a complex of platelet factor 4 (PF4) and heparin, is a well-recognized risk factor for thromboembolic complications. The frequency of antibody development varies among patient populations. Hemodialysis patients have repeated heparin exposure and should be at risk of developing HIT. This might, contribute to the development of vascular access thrombosis. We prospectively evaluated 88 hemodialysis patients for the presence of anti-PF4/heparin antibodies. Eighteen patients (20%) had a prior history of 1 or more prior access thrombosis. One patient (1.14%), without a history of graft thrombosis, tested positive for anti-PF4/heparin antibodies. In our study, the presence of anti-PF4/heparin antibodies was rare and was not increased in patients with a history of vascular access thrombosis.
authors.affiliation: Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. oshea005@mc.duke.edu
authors.forename: Susan I
authors.initials: SI
authors.lastname: O'Shea
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Sands
authors.forename: Sybil A
authors.initials: SA
authors.lastname: Nudo
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Ortel
mesh_terms: D000906:Antibodies / Q000097:blood*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006493:Heparin / Q000009:adverse effects / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D010978:Platelet Factor 4 / Q000276:immunology* / Q000378:metabolism; D011446:Prospective Studies; D012008:Recurrence; D006435:Renal Dialysis; D013921:Thrombocytopenia / Q000139:chemically induced; D013927:Thrombosis / Q000209:etiology* / Q000276:immunology*
chemical_list: D000906:Antibodies; D010978:Platelet Factor 4; D006493:Heparin