Minimal intraoperative anticoagulation strategy for lung transplantation with preoperative heparin-induced thrombocytopenia

JHLT Open 2026 Open access

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Authors: Neelesh Bagrodia, Ammu V. Alvarez, Doug A. Gouchoe, Bryan A. Whitson, Matthew C. Henn, Kukbin Choi
DOI: 10.1016/j.jhlto.2026.100517
Cited by: 1
References: 4

Abstract

Heparin-induced thrombocytopenia (HIT) in patients on mechanical circulatory support (MCS) prior to lung transplantation poses a unique challenge of balancing thrombotic versus hemorrhagic complications. An alternative method of anticoagulation is bivalirudin, offering advantages of rapid titration and a short half-life. We present 2 cases of patients on MCS who developed HIT and were anticoagulated with bivalirudin preoperatively. Contingent on whether additional cannulation was required at the time of lung transplantation, bivalirudin was held either at incision or after cannulation. Both patients were successfully transplanted without coagulopathic complications.

Fields of Study & Subjects

Heparin-Induced Thrombocytopenia and Thrombosis Trauma Hemostasis Coagulopathy Resuscitation Intramuscular injections and effects

Publication details

Journal / source
JHLT Open
Publisher
Elsevier BV
Volume
12
Pages
100517–100517
Publication date
9 February 2026
Language
EN