Treatment of Heparin-Induced Thrombocytopenia

Andreas Greinacher

doi:10.1055/s-0037-1615866

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 1999; 82(02): 457-467
DOI: 10.1055/s-0037-1615866

Research Article

Schattauer GmbH

Treatment of Heparin-Induced Thrombocytopenia

Authors

Andreas Greinacher

¹Institute for Immunology and Transfusion Medicine, Ernst-Moritz-Arndt-University, Greifswald, GERMANY

Abstract

Introduction

Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are the most widely used anticoagulants when parenteral anticoagulation with a short half-life is required. Both can be administered subcutaneously and intravenously, and both have been shown to be effective in a variety of clinical settings.¹ UFH has several limitations. One is its poor bioavailability after subcutaneous injection and the marked variability in its anticoagulant response in patients with an acute thromboembolic complication.^2,3 Another major issue associated with UFH is the induction of heparin-induced thrombocytopenia (HIT). Both limitations are closely linked,⁴ as the underlying cause is the high density of negative charges on the heparin molecule and its molecular weight. Both are responsible for the binding of heparin to plasma proteins other than antithrombin (AT), such as platelet factor 4 (PF4) and to several cell types. This leads to heparin-platelet interaction, the formation of HIT antigen (i.e., PF4/heparin complexes), and inhibition of the anticoagulant effect of heparin (aPTT-nonresponder).

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Referenzen

References
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