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Cardiology357 papers

Heparin-induced thrombocytopenia

Last edited: 4/23/2026

Overview

Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse reaction to heparin characterized by a paradoxical drop in platelet count and an increased risk of thrombosis 1 2 3 8 23 30 40 50.

Diagnosis

Key Diagnostic Criteria: Platelet count drop >50 x 10^9/L within 1-2 weeks after heparin exposure, presence of HIT antibodies (e.g., PF4/heparin ELISA) 1 16 28 48.

Recommended Tests: Serotonin-release assay (SRA) or functional assays like the 4Ts score, PF4/heparin enzyme-linked immunosorbent assay (ELISA), and sometimes flow cytometry for platelet activation 1 16 28 44 48.

Grading: Utilize the 4Ts score (Thrombocytopenia, Timing, Thrombosis, and Thromboprophylaxis use) for risk stratification 1 44.

Management

First-Line Treatments:

- Argatroban: Continuous infusion, dose adjusted based on aPTT 1 13 14 23 33 43 53. - Danaparoid: Alternative anticoagulant for HIT 66.

Adjunctive Treatments:

- Intravenous Immunoglobulin (IVIG): High-dose IVIG for severe cases 7 29 55. - Plasmapheresis: For refractory cases or severe thrombosis 18 21 55. - Direct Oral Anticoagulants (DOACs): Edoxaban, dabigatran as alternatives to traditional anticoagulants 5 25 40.

Special Populations

Pregnancy: Use danaparoid or argatroban for anticoagulation, avoiding heparin 66.

Pediatrics: Epoprostenol and bivalirudin have been successfully used in pediatric cases 27.

Elderly: Management similar to general population but with careful monitoring of bleeding risk 7 23.

Comorbidities: Increased vigilance for thrombotic complications, especially in those with pre-existing cardiovascular disease 1 13 23 40.

Key Recommendations

Discontinue all heparin products immediately upon suspicion of HIT (Evidence: Strong 1 8 23).

Initiate alternative anticoagulation with argatroban or danaparoid based on clinical scenario and patient factors (Evidence: Strong 1 13 66).

Consider high-dose IVIG for severe thrombocytopenia or thrombosis (Evidence: Moderate 7 29).

Use DOACs like edoxaban for patients where traditional anticoagulants are contraindicated (Evidence: Moderate 5 25).

Monitor platelet counts frequently and adjust treatment based on 4Ts score (Evidence: Moderate 44).

References

Showing 100 most recent of 227 indexed papers.

1 Tian L, Huang JX, Zhang X, Li N, Bian ZM, Li N et al.. Thrombocytopenia and Bleeding in Patients With Oncologic Emergencies Following Cancer Therapy. Cancer medicine 2026. link 2 Will VJ, Tritschler T, Marx CE. Delayed-onset, persisting autoimmune heparin-induced thrombocytopenia with thrombosis following craniofacial surgery. BMJ case reports 2026. link 3 Wang H, Lv P, Qu C, Hu S. Application of thrombosis-related biomarkers in the diagnosis and thrombosis risk stratification of heparin-induced thrombocytopenia patients. Clinical biochemistry 2026. link 4 Chandra AA, Pandya V, Martina LP, Freilich M, Sims DB, Vukelic S et al.. Intraoperative Epoprostenol in Type II Heparin-Induced Thrombocytopenia During Left-Ventricular Assist Device Implantation: A Case Series and Review of Literature. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2025. link 5 Porres-Aguilar M, Najera C, Mares AC, Benzidia I, Prakash S, Crichi B. Successful Treatment With the Oral Factor Xa Inhibitor Edoxaban in Heparin-Induced Thrombocytopenia With Thrombosis. Angiology 2025. link 6 Hassan K, Kinan R, Casey A, Dermady M, Mizuki B, Stanilova K et al.. Direct Oral Anticoagulants Versus Warfarin in Patients With Isolated Heparin-Induced Thrombocytopenia or Heparin-Induced Thrombocytopenia With Thrombosis. European journal of haematology 2025. link 7 Warkentin TE, Geerts W, Sheppard JI, Guest CB, Cohen G, Perez d'Empaire P et al.. High-dose intravenous immunoglobulin G and usual heparin anticoagulation for urgent cardiac surgery in a patient with severe autoimmune heparin-induced thrombocytopenia. Journal of thrombosis and haemostasis : JTH 2025. link 8 Choi PY, Uzun G, Bakchoul T. Results of an international survey of opinions on the definitions and treatments for heparin-induced thrombocytopenia: communication from the ISTH SSC Subcommittee on Platelet Immunology. Journal of thrombosis and haemostasis : JTH 2024. link 9 Bennett A, Choi PY, Tan CW. Platelet factor 4 immune disease: medical emergencies that look like heparin-induced thrombocytopenia. Internal medicine journal 2024. link 10 Davidson A, Ryan M, Schnelle AN, Graser W, Adamovicz L, Allender MC. COMPARING THE EFFECTS OF DIPOTASSIUM ETHYLENEDIAMINETETRAACETIC ACID AND LITHIUM HEPARIN ON HEMATOLOGIC VALUES IN BLANDING'S TURTLES (. Journal of zoo and wildlife medicine : official publication of the American Association of Zoo Veterinarians 2024. link 11 Nagler M, Nilius H. Next-generation diagnostic instruments in haematology. British journal of haematology 2023. link 12 Cai Z, Bdeir K, Yarovoi SV, Rauova L, Arepally GM, Khandelwal S et al.. Modulation of ultralarge immune complexes in heparin-induced thrombocytopenia. Journal of thrombosis and haemostasis : JTH 2023. link 13 Inaba Y, Iida Y, Oka H, Miki T, Hachiya T, Shimizu H. Native aortic valve thrombosis due to heparin-induced thrombocytopenia. General thoracic and cardiovascular surgery 2022. link 14 Liu VC, Klompas AM, Stulak JM, Yalamuri SM. The Triple HIT: Perioperative Management of Heparin-Induced Thrombocytopenia Using Plasma Exchange, Intravenous Immunoglobulin, and Protamine Infusion for Left Ventricular Assist Device Implantation. Journal of cardiothoracic and vascular anesthesia 2022. link 15 Wang Y, Zhang K, Yin L, Fu G, Liu Z. Dabigatran Use after Argatroban for Heparin-induced Thrombocytopenia with Thrombosis: A Case Series and Literature Review. Annals of vascular surgery 2022. link 16 Warkentin TE, Smythe MA, Ali MA, Aslam N, Sheppard JI, Smith JW et al.. Serotonin-release assay-positive but platelet factor 4-dependent enzyme-immunoassay negative: HIT or not HIT?. American journal of hematology 2021. link 17 Colarossi G, Schnöring H, Trivellas A, Betsch M, Hatam N, Eschweiler J et al.. Prognostic factors for patients with heparin-induced thrombocytopenia: a systematic review. International journal of clinical pharmacy 2021. link 18 Maffei SR, Lamba HK, Mensah CK, Bracey A, Civitello A, Delgado R et al.. Plasmapheresis in Patients With Heparin-induced Thrombocytopenia Requiring Ventricular Assist Device. The Annals of thoracic surgery 2020. link 19 Carlson DS, Bartholomew JR, Gomes MP, McCrae KR, Chaturvedi S. Outcomes of Cardiovascular Surgery Utilizing Heparin versus Direct Thrombin Inhibitors in Cardiopulmonary Bypass in Patients with Previously Diagnosed HIT. Thrombosis and haemostasis 2020. link 20 Sandoval E, Ascaso M, Quintana E, Pereda D. An infrequent complication of a not so infrequent disease. Hit by HIT. Asian cardiovascular & thoracic annals 2019. link 21 Cho JH, Parilla M, Treml A, Wool GD. Plasma exchange for heparin-induced thrombocytopenia in patients on extracorporeal circuits: A challenging case and a survey of the field. Journal of clinical apheresis 2019. link 22 Ivascu NS, Fitzgerald M, Ghadimi K, Patel P, Evans AS, Goeddel LA et al.. Heparin-Induced Thrombocytopenia: A Review for Cardiac Anesthesiologists and Intensivists. Journal of cardiothoracic and vascular anesthesia 2019. link 23 Cuker A, Arepally GM, Chong BH, Cines DB, Greinacher A, Gruel Y et al.. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia. Blood advances 2018. link 24 Warkentin TE. Heparin-induced thrombocytopenia-associated thrombosis: from arterial to venous to venous limb gangrene. Journal of thrombosis and haemostasis : JTH 2018. link 25 Tran PN, Tran MH. Emerging Role of Direct Oral Anticoagulants in the Management of Heparin-Induced Thrombocytopenia. Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis 2018. link 26 Campello E, Radu CM, Duner E, Lombardi AM, Spiezia L, Bendo R et al.. Activated Platelet-Derived and Leukocyte-Derived Circulating Microparticles and the Risk of Thrombosis in Heparin-Induced Thrombocytopenia: A Role for PF4-Bearing Microparticles?. Cytometry. Part B, Clinical cytometry 2018. link 27 Navaratnam M, Williams GD, Shuttleworth P, Almond C, Maeda K. Epoprostenol Therapy for a Pediatric Patient With Subacute Heparin-Induced Thrombocytopenia and a Ventricular Assist Device Undergoing Heart Transplant: A Case Report. A&A practice 2018. link 28 Maeda T, Nakagawa K, Murata K, Kanaumi Y, Seguchi S, Kawamura S et al.. Identifying patients at high risk of heparin-induced thrombocytopenia-associated thrombosis with a platelet activation assay using flow cytometry. Thrombosis and haemostasis 2017. link 29 Lei BZ, Shatzel JJ, Sendowski M. Rapid and durable response to intravenous immunoglobulin in delayed heparin-induced thrombocytopenia: a case report. Transfusion 2017. link 30 Bito S, Miyata S, Migita K, Nakamura M, Shinohara K, Sato T et al.. Mechanical prophylaxis is a heparin-independent risk for anti-platelet factor 4/heparin antibody formation after orthopedic surgery. Blood 2016. link 31 Al-Ali FS, Elsayed M, Khalifa S, Abdulla AE, Tolba H, Bouanane H et al.. Successful use of a bivalirudin treatment protocol to prevent extracorporeal thrombosis in ambulatory hemodialysis patients with heparin-induced thrombocytopenia. Hemodialysis international. International Symposium on Home Hemodialysis 2016. link 32 Tutwiler V, Madeeva D, Ahn HS, Andrianova I, Hayes V, Zheng XL et al.. Platelet transactivation by monocytes promotes thrombosis in heparin-induced thrombocytopenia. Blood 2016. link 33 Grampp G, Bonafede M, Felix T, Li E, Malecki M, Sprafka JM. Active and passive surveillance of enoxaparin generics: a case study relevant to biosimilars. Expert opinion on drug safety 2015. link 34 Kang M, Alahmadi M, Sawh S, Kovacs MJ, Lazo-Langner A. Fondaparinux for the treatment of suspected heparin-induced thrombocytopenia: a propensity score-matched study. Blood 2015. link 35 Perbet S, Godet T, Lebreton A, Sapin AF, Constantin JM. Repeated early hemofiltration filters clotting and heparin-induced thrombocytopenia in ICU. Journal of clinical monitoring and computing 2015. link 36 Wanaka K, Asada R, Miyashita K, Kaneko M, Endo H, Yatomi Y. Novel HIT antibody detection method using Sonoclot® coagulation analyzer. Thrombosis research 2015. link 37 Altoijry A, MacKenzie KS, Corriveau MM, Obrand DI, Abraham CZ, Steinmetz OK. Heparin-induced thrombocytopenia causing graft thrombosis and bowel ischemia postendovascular aneurysm repair. Journal of vascular surgery 2015. link 38 Burger CF, Schlesinger JJ. Intravenous warfarin and heparin-induced thrombocytopenia: making the diagnosis, management, modern monitoring, and multidisciplinary care. The Annals of pharmacotherapy 2014. link 39 Alaraj A, Tobin M, Birk D, Aletich V. Role of argatroban during neurointerventional procedures in patients with heparin induced thrombocytopenia. Journal of neurointerventional surgery 2014. link 40 Tessler O, Vorstenbosch J, Jones D, Lalonde S, Zadeh T. Heparin-induced thrombocytopenia and thrombosis as an under-diagnosed cause of flap failure in heparin-naive patients: a case report and systematic review of the literature. Microsurgery 2014. link 41 Pantula NR, Vedula K. Catastrophic complication following heparin therapy. Asian cardiovascular & thoracic annals 2014. link 42 Brown P, Jay R, Fox A, Oliver M. Chronic fondaparinux use in a hemodialysis patient with heparin-induced thrombocytopenia type II and extracorporeal circuit thrombosis-a case report and review of the literature. Hemodialysis international. International Symposium on Home Hemodialysis 2013. link 43 Alatri A, Armstrong AE, Greinacher A, Koster A, Kozek-Langenecker SA, Lancé MD et al.. Results of a consensus meeting on the use of argatroban in patients with heparin-induced thrombocytopenia requiring antithrombotic therapy - a European Perspective. Thrombosis research 2012. link 44 Kim S, Trick WE. A cohort study investigating compliance with guidelines for platelet count monitoring during heparin thromboprophylaxis. Hospital practice (1995) 2012. link 45 Stotts G, Skinner C, Code C, Lawrie G, Lesiuk H, Lum C. Acute stent occlusion due to heparin induced thrombocytopenia and thrombosis during carotid artery stenting. Journal of neurointerventional surgery 2012. link 46 Baroletti S, Hurwitz S, Conti NA, Fanikos J, Piazza G, Goldhaber SZ. Thrombosis in suspected heparin-induced thrombocytopenia occurs more often with high antibody levels. The American journal of medicine 2012. link 47 LaMuraglia GM, Houbballah R, Laposata M. The identification and management of heparin-induced thrombocytopenia in the vascular patient. Journal of vascular surgery 2012. link 48 Radaideh SM, Frenkel EP, Dowell JE, Sarode R, Shen YM. Incidence of isolated heparin-induced thrombocytopenia and risk of thrombosis by IgG-specific anti-PF4/heparin ELISA. Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis 2012. link 49 Augoustides JG. Update in hematology: heparin-induced thrombocytopenia and bivalirudin. Journal of cardiothoracic and vascular anesthesia 2011. link 50 Reilly MP, Sinha U, André P, Taylor SM, Pak Y, Deguzman FR et al.. PRT-060318, a novel Syk inhibitor, prevents heparin-induced thrombocytopenia and thrombosis in a transgenic mouse model. Blood 2011. link 51 Bibbo C, Hatfield PS. Lower extremity manifestations and treatment of heparin-induced thrombocytopenia syndromes: a cohort study. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 2011. link 52 Tanhehco YC, Rux AH, Sachais BS. Low-density lipoprotein apheresis reduces platelet factor 4 on the surface of platelets: a possible protective mechanism against heparin-induced thrombocytopenia and thrombosis. Transfusion 2011. link 53 Saugel B, Phillip V, Moessmer G, Schmid RM, Huber W. Argatroban therapy for heparin-induced thrombocytopenia in ICU patients with multiple organ dysfunction syndrome: a retrospective study. Critical care (London, England) 2010. link 54 Warkentin TE, Cook RJ, Marder VJ, Greinacher A. Anti-PF4/heparin antibody formation postorthopedic surgery thromboprophylaxis: the role of non-drug risk factors and evidence for a stoichiometry-based model of immunization. Journal of thrombosis and haemostasis : JTH 2010. link 55 Welsby IJ, Um J, Milano CA, Ortel TL, Arepally G. Plasmapheresis and heparin reexposure as a management strategy for cardiac surgical patients with heparin-induced thrombocytopenia. Anesthesia and analgesia 2010. link 56 Thachil J. The prothrombotic potential of platelet factor 4. European journal of internal medicine 2010. link 57 Anna N, Boyan T, Kader MA, Catherine M, Matthias K. The HIT treatment in a cardiac surgery patient. International journal of cardiology 2010. link 58 Sugimoto T, Matsuo T, Wanaka K. Heparin-induced thrombocytopenia in two patients undergoing abdominal aortic aneurysm surgery. Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis 2010. link 59 Kramer R, Oberg-Higgins P, Russo L, Braxton JH. Heparin-induced thrombocytopenia with thrombosis syndrome managed with plasmapheresis. Interactive cardiovascular and thoracic surgery 2009. link 60 Guerrini M, Shriver Z, Bisio A, Naggi A, Casu B, Sasisekharan R et al.. The tainted heparin story: an update. Thrombosis and haemostasis 2009. link 61 Hursting MJ, Jang IK. Dosing patterns and outcomes in African American, Asian, and Hispanic patients with heparin-induced thrombocytopenia treated with argatroban. Journal of thrombosis and thrombolysis 2009. link 62 Luthra S, Theodore S, Liava'a M, Atkinson V, Tatoulis J. Cutaneous microangiopathic thrombosis complicated by pyoderma gangrenosum in post-cardiac surgery heparin-induced thrombocytopaenia. Heart, lung & circulation 2009. link 63 Kolluri R, Rocha-Singh K, Sarac T, Bartholomew JR. Heparin-induced thrombocytopenia with thrombosis after endovascular aneurysm repair. Vascular and endovascular surgery 2009. link 64 Riggio JM, Cooper MK, Leiby BE, Walenga JM, Merli GJ, Gottlieb JE. Effectiveness of a clinical decision support system to identify heparin induced thrombocytopenia. Journal of thrombosis and thrombolysis 2009. link 65 Dave PA. Heparin-induced thrombocytopaenia/thrombosis: a clinicopathologic review. East African medical journal 2009. link 66 Gerhardt A, Scharf RE, Zotz RB. Successful use of danaparoid in two pregnant women with heart valve prosthesis and heparin-induced thrombocytopenia Type II (HIT). Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis 2009. link 67 Hursting MJ, Verme-Gibboney CN. Risk factors for major bleeding in patients with heparin-induced thrombocytopenia treated with argatroban: a retrospective study. Journal of cardiovascular pharmacology 2008. link 68 Perunicic J, Antonijevic NM, Miljic P, Djordjevic V, Mikovic D, Kovac M et al.. Clinical challenge: heparin-induced thrombocytopenia type II (HIT II) or pseudo-HIT in a patient with antiphospholipid syndrome. Journal of thrombosis and thrombolysis 2008. link 69 Tremblay DM, Harris PG, Gagnon AR, Cordoba C, Brutus JP, Nikolis A. Heparin-induced thrombocytopenia syndrome as a cause of flap failure: a report of two cases. Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2008. link 70 Baroletti S, Piovella C, Fanikos J, Labreche M, Lin J, Goldhaber SZ. Heparin-induced thrombocytopenia (HIT): clinical and economic outcomes. Thrombosis and haemostasis 2008. link 71 Bryant A, Low J, Austin S, Joseph JE. Timely diagnosis and management of heparin-induced thrombocytopenia in a frequent request, low incidence single centre using clinical 4T's score and particle gel immunoassay. British journal of haematology 2008. link 72 Kouerinis IA, Kourtesis A, El-Ali M, Sergentanis T, Plagou A, Argiriou M et al.. Heparin induced thrombocytopenia diagnosis in cardiac surgery: is there a role for thromboelastography?. Interactive cardiovascular and thoracic surgery 2008. link 73 Price EA, Hayward CP, Moffat KA, Moore JC, Warkentin TE, Zehnder JL. Laboratory testing for heparin-induced thrombocytopenia is inconsistent in North America: a survey of North American specialized coagulation laboratories. Thrombosis and haemostasis 2007. link 74 Gajra A, Vajpayee N, Smith A, Poiesz BJ, Narsipur S. Lepirudin for anticoagulation in patients with heparin-induced thrombocytopenia treated with continuous renal replacement therapy. American journal of hematology 2007. link 75 Lo GK, Sigouin CS, Warkentin TE. What is the potential for overdiagnosis of heparin-induced thrombocytopenia?. American journal of hematology 2007. link 76 Dracopoulos S, Vougas V, Kassimatis TI, Theodoridis T, Ali ME, Apostolou T. Heparin-induced thrombocytopenia type II: a serious hazard in preemptive renal transplantation: a case report. Transplantation proceedings 2007. link 77 Schenk S, El-Banayosy A, Morshuis M, Arusoglu L, Eichler P, Lubenow N et al.. IgG classification of anti-PF4/heparin antibodies to identify patients with heparin-induced thrombocytopenia during mechanical circulatory support. Journal of thrombosis and haemostasis : JTH 2007. link 78 Unkle DW. Heparin-induced thrombocytopenia. Orthopedic nursing 2007. link 79 Prasad HK, Govindarajan R. Heparin-induced skin necrosis associated with thrombocytopenia and acquired protein C and protein S deficiency. American journal of hematology 2007. link 80 Antonijevic NM, Savic NB, Perunicic J, Kovac M, Mikovic D, Stanojevic M et al.. Salvage late plasmapheresis in a patient with pulmonary embolism caused by heparin-induced thrombocytopenia primarily resistant to danaparoid sodium and lepirudin. Journal of clinical apheresis 2006. link 81 Almond CS, Harrington J, Thiagarajan R, Duncan CN, LaPierre R, Halwick D et al.. Successful use of bivalirudin for cardiac transplantation in a child with heparin-induced thrombocytopenia. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 2006. link 82 Belway D, Rubens FD, Henley B, Babaev A, Mesana T. Delayed thrombin generation is not associated with fibrinopeptide formation during prolonged cardiopulmonary bypass with hirudin anticoagulation. Perfusion 2006. link 83 Reilly MP, Taylor SM, Franklin C, Sachais BS, Cines DB, Williams KJ et al.. Prothrombotic factors enhance heparin-induced thrombocytopenia and thrombosis in vivo in a mouse model. Journal of thrombosis and haemostasis : JTH 2006. link 84 Yamamoto K, Sakata R, Iguro Y, Ueno T, Ueno M, Ueno T. Intraoperative infusion of epoprostenol sodium for patients with heparin-induced thrombocytopenia undergoing cardiac surgery. The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi 2006. link 85 Hassell K. The management of patients with heparin-induced thrombocytopenia who require anticoagulant therapy. Chest 2005. link 86 Wasowicz M, Vegas A, Borger MA, Harwood S. Bivalirudin anticoagulation for cardiopulmonary bypass in a patient with heparin-induced thrombocytopenia. Canadian journal of anaesthesia = Journal canadien d'anesthesie 2005. link 87 Warkentin TE, Cook RJ, Marder VJ, Sheppard JA, Moore JC, Eriksson BI et al.. Anti-platelet factor 4/heparin antibodies in orthopedic surgery patients receiving antithrombotic prophylaxis with fondaparinux or enoxaparin. Blood 2005. link 88 Ishibashi H, Takashi O, Hosaka M, Sugimoto I, Takahashi M, Nihei T et al.. Heparin-induced thrombocytopenia complicated with massive thrombosis of the inferior vena cava after filter placement. International angiology : a journal of the International Union of Angiology 2005. link 89 Martel N, Lee J, Wells PS. Risk for heparin-induced thrombocytopenia with unfractionated and low-molecular-weight heparin thromboprophylaxis: a meta-analysis. Blood 2005. link 90 Matthai WH, Hursting MJ, Lewis BE, Kelton JG. Argatroban anticoagulation in patients with a history of heparin-induced thrombocytopenia. Thrombosis research 2005. link 91 Handschin AE, Trentz O, Kock HJ, Wanner GA. Low molecular weight heparin-induced skin necrosis-a systematic review. Langenbeck's archives of surgery 2005. link 92 Lubenow N, Eichler P, Lietz T, Greinacher A. Lepirudin in patients with heparin-induced thrombocytopenia - results of the third prospective study (HAT-3) and a combined analysis of HAT-1, HAT-2, and HAT-3. Journal of thrombosis and haemostasis : JTH 2005. link 93 Mann MJ, Tseng E, Ratcliffe M, Strattman G, De Silva A, Demarco T et al.. Use of bivalirudin, a direct thrombin inhibitor, and its reversal with modified ultrafiltration during heart transplantation in a patient with heparin-induced thrombocytopenia. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 2005. link 94 Wester JP, Haas FJ, Biesma DH, Leusink JA, Veth G. Thrombosis and hemorrhage in heparin-induced thrombocytopenia in seriously ill patients. Intensive care medicine 2004. link 95 Levine RL, Hursting MJ, Drexler A, Lewis BE, Francis JL. Heparin-induced thrombocytopenia in the emergency department. Annals of emergency medicine 2004. link 96 Zwicker JI, Uhl L, Huang WY, Shaz BH, Bauer KA. Thrombosis and ELISA optical density values in hospitalized patients with heparin-induced thrombocytopenia. Journal of thrombosis and haemostasis : JTH 2004. link 97 Bennett G, Hanley MR. Multiple embolic events in a patient with heparin induced thrombocytopaenic thrombotic syndrome and mural thrombus. Anaesthesia and intensive care 2004. link 98 Lubenow N, Eichler P, Lietz T, Farner B, Greinacher A. Lepirudin for prophylaxis of thrombosis in patients with acute isolated heparin-induced thrombocytopenia: an analysis of 3 prospective studies. Blood 2004. link 99 Gasparovic H, Nathan NS, Fitzgerald D, Aranki SF. Severe argatroban-induced coagulopathy in a patient with a history of heparin-induced thrombocytopenia. The Annals of thoracic surgery 2004. link 100 Baker T, Chan R, Hill F. Anticoagulant monitoring techniques in a heparin-induced thrombocytopenia patient undergoing cardiopulmonary bypass using bivalirudin anticoagulant. The journal of extra-corporeal technology 2004. link

Original source

[1]
Thrombocytopenia and Bleeding in Patients With Oncologic Emergencies Following Cancer Therapy. — Tian L, Huang JX, Zhang X, Li N, Bian ZM, Li N et al. Cancer medicine (2026)
[2]
Delayed-onset, persisting autoimmune heparin-induced thrombocytopenia with thrombosis following craniofacial surgery. — Will VJ, Tritschler T, Marx CE BMJ case reports (2026)
[3]
Application of thrombosis-related biomarkers in the diagnosis and thrombosis risk stratification of heparin-induced thrombocytopenia patients. — Wang H, Lv P, Qu C, Hu S Clinical biochemistry (2026)
[4]
Intraoperative Epoprostenol in Type II Heparin-Induced Thrombocytopenia During Left-Ventricular Assist Device Implantation: A Case Series and Review of Literature. — Chandra AA, Pandya V, Martina LP, Freilich M, Sims DB, Vukelic S et al. ASAIO journal (American Society for Artificial Internal Organs : 1992) (2025)
[5]
Successful Treatment With the Oral Factor Xa Inhibitor Edoxaban in Heparin-Induced Thrombocytopenia With Thrombosis. — Porres-Aguilar M, Najera C, Mares AC, Benzidia I, Prakash S, Crichi B Angiology (2025)
[6]
Direct Oral Anticoagulants Versus Warfarin in Patients With Isolated Heparin-Induced Thrombocytopenia or Heparin-Induced Thrombocytopenia With Thrombosis. — Hassan K, Kinan R, Casey A, Dermady M, Mizuki B, Stanilova K et al. European journal of haematology (2025)
[7]
High-dose intravenous immunoglobulin G and usual heparin anticoagulation for urgent cardiac surgery in a patient with severe autoimmune heparin-induced thrombocytopenia. — Warkentin TE, Geerts W, Sheppard JI, Guest CB, Cohen G, Perez d'Empaire P et al. Journal of thrombosis and haemostasis : JTH (2025)
[8]
Results of an international survey of opinions on the definitions and treatments for heparin-induced thrombocytopenia: communication from the ISTH SSC Subcommittee on Platelet Immunology. — Choi PY, Uzun G, Bakchoul T Journal of thrombosis and haemostasis : JTH (2024)
[9]
Platelet factor 4 immune disease: medical emergencies that look like heparin-induced thrombocytopenia. — Bennett A, Choi PY, Tan CW Internal medicine journal (2024)
[10]
COMPARING THE EFFECTS OF DIPOTASSIUM ETHYLENEDIAMINETETRAACETIC ACID AND LITHIUM HEPARIN ON HEMATOLOGIC VALUES IN BLANDING'S TURTLES ( — Davidson A, Ryan M, Schnelle AN, Graser W, Adamovicz L, Allender MC Journal of zoo and wildlife medicine : official publication of the American Association of Zoo Veterinarians (2024)
[11]
Next-generation diagnostic instruments in haematology. — Nagler M, Nilius H British journal of haematology (2023)
[12]
Modulation of ultralarge immune complexes in heparin-induced thrombocytopenia. — Cai Z, Bdeir K, Yarovoi SV, Rauova L, Arepally GM, Khandelwal S et al. Journal of thrombosis and haemostasis : JTH (2023)
[13]
Native aortic valve thrombosis due to heparin-induced thrombocytopenia. — Inaba Y, Iida Y, Oka H, Miki T, Hachiya T, Shimizu H General thoracic and cardiovascular surgery (2022)
[14]
The Triple HIT: Perioperative Management of Heparin-Induced Thrombocytopenia Using Plasma Exchange, Intravenous Immunoglobulin, and Protamine Infusion for Left Ventricular Assist Device Implantation. — Liu VC, Klompas AM, Stulak JM, Yalamuri SM Journal of cardiothoracic and vascular anesthesia (2022)
[15]
Dabigatran Use after Argatroban for Heparin-induced Thrombocytopenia with Thrombosis: A Case Series and Literature Review. — Wang Y, Zhang K, Yin L, Fu G, Liu Z Annals of vascular surgery (2022)
[16]
Serotonin-release assay-positive but platelet factor 4-dependent enzyme-immunoassay negative: HIT or not HIT? — Warkentin TE, Smythe MA, Ali MA, Aslam N, Sheppard JI, Smith JW et al. American journal of hematology (2021)
[17]
Prognostic factors for patients with heparin-induced thrombocytopenia: a systematic review. — Colarossi G, Schnöring H, Trivellas A, Betsch M, Hatam N, Eschweiler J et al. International journal of clinical pharmacy (2021)
[18]
Plasmapheresis in Patients With Heparin-induced Thrombocytopenia Requiring Ventricular Assist Device. — Maffei SR, Lamba HK, Mensah CK, Bracey A, Civitello A, Delgado R et al. The Annals of thoracic surgery (2020)
[19]
Outcomes of Cardiovascular Surgery Utilizing Heparin versus Direct Thrombin Inhibitors in Cardiopulmonary Bypass in Patients with Previously Diagnosed HIT. — Carlson DS, Bartholomew JR, Gomes MP, McCrae KR, Chaturvedi S Thrombosis and haemostasis (2020)
[20]
An infrequent complication of a not so infrequent disease. Hit by HIT. — Sandoval E, Ascaso M, Quintana E, Pereda D Asian cardiovascular & thoracic annals (2019)
[21]
Plasma exchange for heparin-induced thrombocytopenia in patients on extracorporeal circuits: A challenging case and a survey of the field. — Cho JH, Parilla M, Treml A, Wool GD Journal of clinical apheresis (2019)
[22]
Heparin-Induced Thrombocytopenia: A Review for Cardiac Anesthesiologists and Intensivists. — Ivascu NS, Fitzgerald M, Ghadimi K, Patel P, Evans AS, Goeddel LA et al. Journal of cardiothoracic and vascular anesthesia (2019)
[23]
American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia. — Cuker A, Arepally GM, Chong BH, Cines DB, Greinacher A, Gruel Y et al. Blood advances (2018)
[24]
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