uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
The severity of trauma determines the immune response to PF4/heparin and the frequency of heparin-induced thrombocytopenia.
Department of Transfusion Medicine, Greifswald University, Germany.
Show others and affiliations
2010 (English)In: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 115, no 9, 1797-803 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2010. Vol. 115, no 9, 1797-803 p.
National Category
Clinical Medicine
URN: urn:nbn:se:uu:diva-161334DOI: 10.1182/blood-2009-07-231506PubMedID: 19965682OAI: oai:DiVA.org:uu-161334DiVA: diva2:455808
Available from: 2011-11-11 Created: 2011-11-11 Last updated: 2011-11-30

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Lubenow, Norbert
In the same journal
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 147 hits
ReferencesLink to record
Permanent link

Direct link