title: Successful use of bivalirudin for cardiac transplantation in a child with heparin-induced thrombocytopenia.
abstract: 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.
authors.affiliation: Department of Cardiology, Children's Hospital, Boston, Massachusetts 02215, USA. christopher.almond@childrens.harvard.edu <christopher.almond@childrens.harvard.edu>
authors.forename: Christopher S D
authors.initials: CS
authors.lastname: Almond
authors.forename: James
authors.initials: J
authors.lastname: Harrington
authors.forename: Ravi
authors.initials: R
authors.lastname: Thiagarajan
authors.forename: Christine N
authors.initials: CN
authors.lastname: Duncan
authors.forename: Robert
authors.initials: R
authors.lastname: LaPierre
authors.forename: David
authors.initials: D
authors.lastname: Halwick
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Blume
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Del Nido
authors.forename: Ellis J
authors.initials: EJ
authors.lastname: Neufeld
authors.forename: Francis X
authors.initials: FX
authors.lastname: McGowan
mesh_terms: 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
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; D013917:Thrombin; C074619:bivalirudin