title: Perioperative management of partial face transplantation involving a heparin antibody-positive donor.
abstract: Heparin-induced thrombocytopenia (HIT) is an immunologic condition that may lead to thrombosis. We present a case of face transplantation from a donor who had suffered a severe stroke, possibly from HIT, during cardiac surgery. The procedure was planned to include full heparinization. The anesthesia team was involved in the early planning phase and had detailed access to the donor's medical history; alternative anticoagulation for the donor and recipient was suggested so as to avoid a possible complication.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. tedrich@partners.org
authors.forename: Thomas
authors.initials: T
authors.lastname: Edrich
authors.forename: Bohdan
authors.initials: B
authors.lastname: Pomahac
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Lu
authors.forename: Gregory Stephen
authors.initials: GS
authors.lastname: Couper
authors.forename: Peter
authors.initials: P
authors.lastname: Gerner
mesh_terms: D000906:Antibodies / Q000097:blood; D000925:Anticoagulants / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D054445:Facial Transplantation / Q000379:methods*; D006493:Heparin / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D013921:Thrombocytopenia / Q000139:chemically induced / Q000517:prevention & control*; D014019:Tissue Donors
chemical_list: D000906:Antibodies; D000925:Anticoagulants; D006493:Heparin