American Society of Hirudotherapy

Developing an algorithm for treating heparin-induced thrombocytopenia.

Research article published in Clinical advances in hematology & oncology : H&O (2004)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentMcIntosh · Clinical advances in hematology & oncology : H&O, 2004

Abstract

Heparin-induced thrombocytopenia (HIT) is a serious and common complication of heparin therapy that can lead to significant losses of life and limb. It is often under-recognized and, therefore, goes untreated until thrombosis develops. This article is meant to provide specific recommendations for treating patients with immune-mediated HIT, whether or not it is associated with thrombosis. These recommendations are based on our clinical experience treating patients with HIT and our evaluation of the published data on the efficacy and safety of lepirudin and argatroban, the 2 drugs approved by the Food and Drug Administration for treating HIT. Based on these criteria, we consider lepirudin the treatment of choice in all patients with HIT except those with severe or deteriorating renal function.

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

Publication typeJournal ArticleReview
Indexed MeSH termsAlgorithmsAnticoagulantsAntigen-Antibody ComplexArginineClinical Trials as TopicDiagnosis, DifferentialDisease ManagementFollow-Up StudiesHemorrhageHeparinHeparin, Low-Molecular-WeightHirudins

Summary

Developing an algorithm for treating heparin-induced thrombocytopenia.

Why This Matters for Hirudotherapy

This review outlines an algorithm for managing heparin-induced thrombocytopenia (HIT), focusing on the clinical use of FDA-approved alternative anticoagulants. It specifically highlights lepirudin—a recombinant form of hirudin originally derived from the medicinal leech—as the treatment of choice for most HIT patients. This provides valuable context for the clinical translation of a leech-derived protein into a mainstream pharmaceutical. However, the study does not involve live leeches or natural hirudotherapy; its relevance is strictly limited to the pharmaceutical application of a specific leech-derived molecule.

Citation

Developing an algorithm for treating heparin-induced thrombocytopenia.

McIntosh · Clinical advances in hematology & oncology : H&O, 2004

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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