Utility of the 4Ts score in excluding heparin-induced thrombocytopenia in lung transplant recipients

被引:0
作者
Wu, Sara [1 ]
Converse, Maureen P. [2 ]
Alnuaimat, Hassan M. [3 ]
Veasey, Tara M. [4 ]
机构
[1] Ascens St Vincents, Dept Pharm Serv, 1 Shircliff Way,Suite 1551 Inpatient Pharm, Jacksonville, FL 32204 USA
[2] UF Hlth Shands Hosp, Dept Pharm Serv, Gainesville, FL USA
[3] Univ Florida, Dept Med, Gainesville, FL USA
[4] Allegheny Gen Hosp, Dept Pharm Serv, Pittsburgh, PA 15212 USA
关键词
Heparin-induced thrombocytopenia; HIT; 4Ts score; Lung transplant; VENOUS THROMBOEMBOLISM; DIAGNOSIS;
D O I
10.1007/s11239-020-02249-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Heparin-induced thrombocytopenia (HIT) is a prothrombotic complication following heparin exposure. Data is limited on the incidence of HIT and validity of 4Ts score in the solid organ transplant population. This retrospective observational cohort included patients who underwent lung transplant between August 2015 and June 2018 and had a clinical suspicion of HIT with heparin-PF4 testing. The 4Ts score was correlated with the heparin-PF4 antibody and serotonin release assay (SRA) results, with positive SRA considered confirmed HIT. Of 146 patients evaluated, the overall incidence of HIT was low (2(1%)). Fifty-one patients had heparin-PF4 testing and were included in the cohort; 5 (10%) had positive heparin-PF4 and 1 (2%) had confirmed HIT. The median 4Ts score was 3 (3-4). Thirty (59%), 17 (33%), and 4 (8%) patients had low, intermediate, and high risk, respectively. The intermediate/high risk group compared to the low risk group had a higher use of alternative non-heparin anticoagulation [13 (62%) vs 7 (23%);p = 0.0086)] and a higher incidence of thrombosis [13 (62%) vs 1 (3%);p < 0.0001]. No patient with a low 4Ts score had confirmed HIT, supporting the utility of low 4Ts score to exclude HIT diagnosis in lung transplant recipients.
引用
收藏
页码:814 / 817
页数:4
相关论文
共 9 条
  • [1] Assfalg Volker, 2016, World J Transplant, V6, P165, DOI 10.5500/wjt.v6.i1.165
  • [2] American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia
    Cuker, Adam
    Arepally, Gowthami M.
    Chong, Beng H.
    Cines, Douglas B.
    Greinacher, Andreas
    Gruel, Yves
    Linkins, Lori A.
    Rodner, Stephen B.
    Selleng, Sixten
    Warkentin, Theodore E.
    Wex, Ashleigh
    Mustafa, Reem A.
    Morgan, Rebecca L.
    Santesso, Nancy
    [J]. BLOOD ADVANCES, 2018, 2 (22) : 3360 - 3392
  • [3] Heparin-induced thrombocytopenia: is it a graft-threatening complication?
    Hassan, Syed
    Qureshi, Waqas
    Badami, Ami
    Khoulani, Dania
    Mittal, Chetan
    Amer, Syed
    Alirhayim, Zaid
    Kuriakose, Philip
    [J]. TRANSPLANT INTERNATIONAL, 2013, 26 (04) : 385 - 391
  • [4] Thrombocytopenia due to acute venous thromboembolism and its role in expanding the differential diagnosis of heparin-induced thrombocytopenia
    Kitchens, CS
    [J]. AMERICAN JOURNAL OF HEMATOLOGY, 2004, 76 (01) : 69 - 73
  • [5] Evaluation of pretest clinical score (4 T's) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings
    Lo, GK
    Juhl, D
    Warkentin, TE
    Sigouin, CS
    Eichler, P
    Greinacher, A
    [J]. JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2006, 4 (04) : 759 - 765
  • [6] Venous Thromboembolism After Adult Lung Transplantation: A Frequent Event Associated With Lower Survival
    Ribeiro Neto, Manuel L.
    Budev, Marie
    Culver, Daniel A.
    Lane, C. Randall
    Gomes, Marcelo
    Wang, Xiao-Feng
    Rocha, Paulo Novis
    Olman, Mitchell A.
    [J]. TRANSPLANTATION, 2018, 102 (04) : 681 - 687
  • [7] Development of a Hypercoagulable Status in Patients Undergoing Off-Pump Lung Transplantation despite Prolonged Conventional Coagulation Tests
    Ruitenbeek, Karin
    Hugenholtz, Greg C. G.
    Adelmeijer, Jelle
    Pereboom, Ilona T. A.
    Meijers, Joost C. M.
    van der Bij, Wim
    Porte, Robert J.
    Erasmus, Michiel E.
    Lisman, Ton
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2015, 191 (02) : 230 - 233
  • [8] Deep vein thrombosis and pulmonary embolism after solid organ transplantation: an unresolved problem
    Saez-Gimenez, Berta
    Berastegui, Cristina
    Loor, Karina
    Lopez-Meseguer, Manuel
    Monforte, Victor
    Bravo, Carlos
    Santamaria, Amparo
    Roman, Antonio
    [J]. TRANSPLANTATION REVIEWS, 2015, 29 (02) : 85 - 92
  • [9] Heparin-Induced Thrombocytopenia A Comprehensive Clinical Review
    Salter, Benjamin S.
    Weiner, Menachem M.
    Trinh, Muoi A.
    Heller, Joshua
    Evans, Adam S.
    Adams, David H.
    Fischer, Gregory W.
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2016, 67 (21) : 2519 - 2532