Low molecular weight heparin-induced thrombocytopenia management during hemodialysis and cardiac surgery: a case report and literature review

被引：0
作者：
Shuto Takada [1 ]
Shogo Suzuki [1 ]
Takahiro Tamura [2 ]
机构：
[1] Department of Anesthesiology, Nagoya University Hospital, Nagoya
[2] Department of Anesthesiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya
来源：
JA Clinical Reports | / 11卷 / 1期
关键词：
Dalteparin; Heparin-induced thrombocytopenia; Low molecular weight heparin;
D O I：
10.1186/s40981-025-00781-0
中图分类号：
学科分类号：
摘要：
Background: Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy, including low molecular weight heparins (LMWHs) like dalteparin. While LMWHs reduces the risk of HIT compared to unfractionated heparin, vigilance remains essential. Case presentation: An 82-year-old male with chronic kidney disease (CKD) developed HIT during hemodialysis anticoagulation with dalteparin, resulting in a platelet count of 17,000/µL and positive HIT antibodies. Dalteparin was replaced with nafamostat mesilate. Following confirmed HIT antibody seronegativity, elective aortic valve replacement was performed under cardiopulmonary bypass using heparin. Postoperative dialysis was managed using nafamostat mesilate, preventing HIT recurrence. His platelet count recovered after dalteparin replacement, and no recurrence of HIT was observed. Conclusions: Even LMWHs, such as dalteparin, pose a HIT risk, necessitating vigilant monitoring. Confirming HIT antibody seronegativity and appropriately timing surgery are critical for patients with a history of HIT. Proper postoperative follow-up and alternative anticoagulation strategies can prevent HIT recurrence. © The Author(s) 2025.
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