title: Low dose bivalirudin anticoagulation for lung transplantation with extracorporeal membrane oxygenation in a patient with acute heparin-induced thrombocytopenia.
abstract: A patient scheduled for lung transplantation needed veno-venous extracorporeal membrane oxygenation (ECMO) and developed acute heparin-induced thrombocytopenia (HIT). After 21 days on ECMO support, lung transplantation was successfully performed using veno-arterial ECMO with bivalirudin anticoagulation. The target activating clotting time values of 160-180 s resulted in low bivalirudin infusion rates of 0.1 mg/kg/h. Diffuse bleeding stopped quickly after ending the continuous bivalirudin infusion.
authors.affiliation: Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Koster
authors.affiliation: Clinic for Internal Medicine and Pneumology, Hospital of Bad Oeynhausen, Bad Oeynhausen, Germany.
authors.forename: Jost
authors.initials: J
authors.lastname: Niedermeyer
authors.affiliation: Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Gummert
authors.affiliation: Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany.
authors.forename: Andre
authors.initials: A
authors.lastname: Renner
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006629:Hirudins; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced*
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin
keywords: Anticoagulation; Extracorporeal Circulation; HIT