Successful use of bivalirudin for cardiac transplantation in a child with heparin-induced thrombocytopenia.
Bivalirudin, a direct thrombin inhibitor, has recently emerged as a promising option for anti-coagulation during cardiopulmonary bypass in patients who cannot receive heparin. There is limited experience with the use of bivalirudin in children. We present the case of a child with heparin-induced thrombocytopenia with thrombosis (HIT Type II) who underwent successful orthotopic cardiac transplantation using bivalirudin as the primary anti-coagulant for cardiopulmonary bypass.
Almond
Christopher S D
CS
Department of Cardiology, Children's Hospital, Boston, Massachusetts 02215, USA. christopher.almond@childrens.harvard.edu <christopher.almond@childrens.harvard.edu>
Harrington
James
J
Thiagarajan
Ravi
R
Duncan
Christine N
CN
LaPierre
Robert
R
Halwick
David
D
Blume
Elizabeth D
ED
Del Nido
Pedro J
PJ
Neufeld
Ellis J
EJ
McGowan
Francis X
FX
D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass / Q000379:methods; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D016027:Heart Transplantation; D006493:Heparin / Q000009:adverse effects*; D006629:Hirudins / Q000009:adverse effects; D006801:Humans; D010446:Peptide Fragments / Q000009:adverse effects / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D013917:Thrombin / Q000037:antagonists & inhibitors; D013921:Thrombocytopenia / Q000139:chemically induced*; D013927:Thrombosis / Q000188:drug therapy / Q000517:prevention & control
D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; D013917:Thrombin; C074619:bivalirudin