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Sökning: onr:"swepub:oai:DiVA.org:uu-161334" > The severity of tra...

The severity of trauma determines the immune response to PF4/heparin and the frequency of heparin-induced thrombocytopenia.

Lubenow, Norbert (författare)
Department of Transfusion Medicine, Greifswald University, Germany
Hinz, Peter (författare)
Thomaschewski, Simone (författare)
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Lietz, Theresia (författare)
Vogler, Michael (författare)
Ladwig, Andrea (författare)
Jünger, Michael (författare)
Nauck, Matthias (författare)
Schellong, Sebastian (författare)
Wander, Kathrin (författare)
Engel, Georg (författare)
Ekkernkamp, Axel (författare)
Greinacher, Andreas (författare)
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 (creator_code:org_t)
2010
2010
Engelska.
Ingår i: Blood. - 0006-4971 .- 1528-0020. ; 115:9, s. 1797-803
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Heparin can induce heparin-induced thrombocytopenia (HIT). The combined effect of type of surgery (major vs minor) and heparin on this prothrombotic immune reaction to platelet factor 4 (PF4)/heparin was analyzed. In a randomized, double-blind study, trauma patients receiving low-molecular-weight (LMWH) or unfractionated heparin (UFH) for thrombosis prophylaxis were assessed for PF4/heparin-antibody seroconversion, HIT, and thrombosis according to type of surgery. The risk for seroconversion was higher than major versus minor surgery odds ratio, 7.98 [95% confidence interval, 2.06-31.00], P = .003, controlled for potential confounders, as was the risk for HIT (2.2% [95% confidence interval, 0.3%-4.1%] vs 0.0%, P = .010). During LMWH compared with UFH thromboprophylaxis, HIT (1 of 298 vs 4 of 316; P = .370) and PF4/heparin seroconversion (1.7% vs 6.6%; P = .002) were less frequent, driven by differences in patients undergoing major surgery (incidence of HIT: LMWH 0.8% vs UFH 4.0%; P = .180; seroconversion rates: 4.0% vs 17.0%; P = .001). After minor surgery, no case of HIT occurred. The severity of trauma and the need for major surgery strongly influence the risk of an anti-PF4/heparin immune response, which is then increased by UFH. In major trauma certoparin may be safer than UFH because it induces HIT-antibody seroconversion, and the corresponding risk of HIT, less frequently.

Ämnesord

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

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