Low dose bivalirudin anticoagulation for lung transplantation with extracorporeal membrane oxygenation in a patient with acute heparin-induced thrombocytopenia

Eur J Cardiothorac Surg. 2017 May 1;51(5):1009-1011. doi: 10.1093/ejcts/ezw390.

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.

Keywords: Anticoagulation; Extracorporeal Circulation; HIT.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants* / adverse effects
  • Anticoagulants* / therapeutic use
  • Extracorporeal Membrane Oxygenation / methods*
  • Heparin / adverse effects*
  • Heparin / therapeutic use
  • Hirudins
  • Humans
  • Lung Transplantation / methods*
  • Male
  • Middle Aged
  • Peptide Fragments / therapeutic use*
  • Recombinant Proteins / therapeutic use
  • Thrombocytopenia / chemically induced*

Substances

  • Anticoagulants
  • Hirudins
  • Peptide Fragments
  • Recombinant Proteins
  • Heparin
  • bivalirudin