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Lung transplantation using argatroban in severe heparin-induced thrombocytopenia during extracorporeal membrane oxygenation: a case series

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Abstract

Lung transplantation during heparin-induced thrombocytopenia (HIT) is controversial and often considered a contraindication because of the risk of increased bleeding and thrombosis in the recipient. Although lung transplantation offers the best chance for cure in end-stage lung disease, the outcome after transplantation is still controversial in patients with HIT. In our center, two patients developed HIT type II during venovenous extracorporeal membrane oxygenation (ECMO) support for acute respiratory failure. They underwent successful lung transplantation using argatroban. The subsequent clinical course was uneventful except evacuation of post-operative hematoma in 1 patient, and they were discharged. Argatroban was successfully used during lung transplant surgery in patients who developed HIT type II during ECMO support. Further studies on the feasibility and safety of lung transplantation using a direct thrombin inhibitor in patients with HIT during ECMO are required

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Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan-si, Republic of Korea

    Sung Kwang Lee & Do Hyung Kim

  2. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, Republic of Korea

    Woo Hyun Cho & Hye Ju Yeo

  3. Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Republic of Korea

    Hye Ju Yeo

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  1. Sung Kwang Lee
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  2. Woo Hyun Cho
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  4. Hye Ju Yeo
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Correspondence to Hye Ju Yeo.

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Lee, S.K., Cho, W.H., Kim, D.H. et al. Lung transplantation using argatroban in severe heparin-induced thrombocytopenia during extracorporeal membrane oxygenation: a case series. Gen Thorac Cardiovasc Surg 68, 1565–1568 (2020). https://doi.org/10.1007/s11748-020-01356-9

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  • DOI: https://doi.org/10.1007/s11748-020-01356-9

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