Bivalirudin utilization in rats undergoing cardiopulmonary bypass: preventing the increase of antiheparin/platelet factor 4 antibody in perioperative period.
OBJECTIVE
To investigate the impact of bivalirudin alternative treatment on antiheparin/platelet factor 4 antibody levels perioperatively in rats undergoing cardiopulmonary bypass (CPB).


METHODS
Two groups of rats received heparin pretreatment and two groups of rats not, and during CPB all the four groups received either bivalirudin or heparin. Pre-CPB and post-CPB day 7 venous blood samples were used to determine the levels of antiheparin/PF4 antibody immunoglobulin (Ig) G with enzyme-linked immunosorbent assay.


RESULTS
Preoperative heparin pretreatment increased the antiheparin/PF4 antibody IgG levels (P < .01), while the administration of heparin further increased this levels (P < .01). The use of bivalirudin prevented further increase in antiheparin/PF4 antibody IgG levels.


CONCLUSIONS
Bivalirudin, as a direct thrombin inhibitor, could circumvent the increased antiheparin/PF4 antibody level in circulation due to the heparin administration.
1Department of Anesthesiology, Shanghai Children's Medical, Center School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Ruidong
R
Zhang
Yue
Y
Huang
Mazhong
M
Zhang
Jinfen
J
Liu
D000818:Animals; D000925:Anticoagulants / Q000494:pharmacology*; D000991:Antithrombins / Q000494:pharmacology*; D001323:Autoantibodies / Q000276:immunology / Q000378:metabolism*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D006493:Heparin / Q000276:immunology / Q000494:pharmacology; D006629:Hirudins / Q000494:pharmacology*; D007074:Immunoglobulin G / Q000276:immunology / Q000378:metabolism; D008297:Male; D010446:Peptide Fragments / Q000494:pharmacology*; D010978:Platelet Factor 4 / Q000276:immunology*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D011994:Recombinant Proteins / Q000494:pharmacology
D000925:Anticoagulants; D000991:Antithrombins; D001323:Autoantibodies; D006629:Hirudins; D007074:Immunoglobulin G; D010446:Peptide Fragments; D011994:Recombinant Proteins; D010978:Platelet Factor 4; D006493:Heparin; C074619:bivalirudin