Use of argatroban as anticoagulation for cardiopulmonary bypass during heart transplantation: A case report

Journal of Cardiothoracic Surgery 2026 Open access

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Authors: Marika Faggioli, Daniela Bacich, Chiara Tessari, Fabio Zanella, Demetrio Pittarello, Annalisa Angelini, Augusto D’Onofrio, Vincenzo Tarzia, Gerosa Gino
DOI: 10.1186/s13019-026-04168-9
Cited by: 1
References: 4

Abstract

BACKGROUND: Heparin-induced thrombocytopenia rules out the possibility of adopting heparin for cardiopulmonary bypass. To overcome this problem two anticoagulants can be used: argatroban and bivalirudin. CASE PRESENTATION: We report on the adoption of argatroban during cardiopulmonary bypass for heart transplantation in a patient affected by HIT, previously implanted with a left ventricular assist device. Despite appropriate dosing, anticoagulation reversal proved ineffective, resulting in uncontrollable coagulopathy and fatal haemorrhage. CONCLUSIONS: Argatroban could be an effective option for selected patients but more studies and particular attention are required, especially in patients with previous left ventricular assist device implantation.

Fields of Study & Subjects

Heparin-Induced Thrombocytopenia and Thrombosis Transplantation: Methods and Outcomes Mechanical Circulatory Support Devices

Publication details

Journal / source
Journal of Cardiothoracic Surgery
Publisher
Springer Science and Business Media LLC
Volume
21
Issue
1
Publication date
18 May 2026
Language
EN