American Society of Hirudotherapy

Recognition and management of heparin-induced thrombocytopenia in pediatric cardiopulmonary bypass patients

Clinical review published in Annals of Thoracic Surgery (2006)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportDrug DevelopmentClinical TrialsBoshkov LK et al. · Annals of Thoracic Surgery, 2006

Abstract

Repeated exposure to unfractionated heparin is the rule in many congenital heart disease patients. Heparin-induced thrombocytopenia occurs in 1% to 3% of adult cardiac surgeries, and carries high thrombotic morbidity (38% to 81%) and mortality (approximately 28%). Although heparin-induced thrombocytopenia appears to be infrequent in pediatric patients, particularly neonates, our evolving experience suggests postcardiopulmonary bypass congenital heart disease patients may be at increased risk. Diagnostic and therapeutic challenges include frequency of thrombocytopenia after cardiopulmonary bypass, imperfect laboratory testing, lack of established dosing of alternative anticoagulants (such as argatroban and lepirudin), and increased anticoagulant-related bleeding in young children.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal ArticleReview
Indexed MeSH termsAdolescentAnticoagulantsArginineAutoantibodiesCardiopulmonary BypassChildChild, PreschoolClinical Trials as TopicFatal OutcomeFemaleHeart Defects, CongenitalHeparin

Summary

Reviews HIT incidence (1–3% in adult cardiac surgery, ~28% HIT-related mortality) and the post-CPB pediatric population; describes argatroban and lepirudin dosing limitations and increased bleeding risk in young children.

Why This Matters for Hirudotherapy

This article discusses recognition and management of heparin-induced thrombocytopenia in pediatric cardiopulmonary bypass patients, noting that HIT carries high thrombotic morbidity (38–81%) and mortality (~28%) in adults and that post-bypass congenital heart disease patients may be at increased risk. It identifies argatroban and lepirudin as alternative anticoagulants while noting challenges including lack of established dosing and increased anticoagulant-related bleeding in young children. The abstract does not describe lepirudin's relationship to hirudin or mention leeches. For ASH, the connection to hirudotherapy or the leech secretome is not established by the abstract, which discusses these agents purely as pharmaceutical anticoagulants without reference to biological origins.

Citation

Recognition and management of heparin-induced thrombocytopenia in pediatric cardiopulmonary bypass patients.

Boshkov LK et al. · Annals of Thoracic Surgery, 2006

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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