title: Heparin-induced thrombocytopenia (HIT II) in liver transplant recipients: a retrospective multivariate analysis of prognostic factors.
abstract: We investigated the prevalence of HIT II in liver transplant recipients and analysed associated factors. In recipients with clinically suspected HIT II in the 4Ts pretest clinical scoring system HIPA-assay was performed. Next, 37 clinical variables were analysed retrospectively for their association with HIT II. Factors significantly correlated to our findings in univariate analysis were included in a multivariate model and binary logistic regression analysis. Among 46 recipients 21 patients were suspicious in the 4Ts pretest and 14 of them (30.4%) were diagnosed HIT-antibody positive. Patient's age (P = 0.001), postoperative dialysis (P = 0.028), and postoperative hospital stay (P = 0.035) were significantly associated with development of HIT-antibodies in univariate analysis. Postoperative dialysis and postoperative hospital stay turned out as epiphenomena of patient's age, the only independent predictor (P = 0.021). Using multiple χ(2) -testing, a cut-off could be calculated, assigning patients younger than 59 years to a low risk group and patients of 59 years and older to a high risk group. High incidence of peri-operative HIT II seroconversion in liver transplant recipients is not associated with factors known to induce thrombocyte activation, like blood products or cell-saver. Only patients' age was identified as independent predictor.
authors.affiliation: Department of Surgery, Munich Transplant Centre, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Hüser
authors.forename: Volker
authors.initials: V
authors.lastname: Aßfalg
authors.forename: Daniel
authors.initials: D
authors.lastname: Reim
authors.forename: Alexander
authors.initials: A
authors.lastname: Novotny
authors.forename: Stefan
authors.initials: S
authors.lastname: Thorban
authors.forename: Zhangjun
authors.initials: Z
authors.lastname: Cheng
authors.forename: Arno
authors.initials: A
authors.lastname: Kornberg
authors.forename: Helmut
authors.initials: H
authors.lastname: Friess
authors.forename: Peter
authors.initials: P
authors.lastname: Büchler
authors.forename: Edouard
authors.initials: E
authors.lastname: Matevossian
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D017093:Liver Failure / Q000150:complications / Q000628:therapy; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications
chemical_list: D006493:Heparin