American Society of Hirudotherapy

Management of Heparin-Induced Thrombocytopenia Using Plasmapharesis in Patients Undergoing HeartMate 3 Left Ventricular Assist Device

Research article published in ASAIO journal (2021)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportDrug DevelopmentNaqvi SY et al. · ASAIO journal, 2021

Abstract

Heparin-induced thrombocytopenia (HIT) type-2 is a rare, but life-threatening complication that presents a unique challenge in patients undergoing cardiac surgery. Patients that require cardiac surgery with HIT present a dilemma between intraoperative anticoagulation, perioperative bleeding risk, and perioperative thrombotic events. We describe a case series of four patients who developed HIT in their hospital course before HeartMate 3 (HM3) left ventricular assist device implantation. Following a multidisciplinary approach, all patients did well intraoperatively with an approach of preoperative plasmapheresis, intraoperative unfractionated heparin (UFH), and postoperative conversion to bivalirudin with a bridge to warfarin. However, two patients had postoperative bleeding complications on bivalirudin. This case series details the therapeutic challenges encountered for HM3 implantation in patients with HIT and offers a therapeutic alternative to intraoperative bivalirudin in the effort to decrease perioperative complications in this challenging patient population.

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

Publication typeJournal Article
Indexed MeSH termsAnticoagulantsBlood CoagulationHeart-Assist DevicesHeparinHirudinsHumansPeptide FragmentsRecombinant ProteinsThrombocytopenia

Summary

Management of Heparin-Induced Thrombocytopenia Using Plasmapharesis in Patients Undergoing HeartMate 3 Left Ventricular Assist Device.

Why This Matters for Hirudotherapy

This case series describes four patients with heparin-induced thrombocytopenia (HIT) who underwent HeartMate 3 left ventricular assist device implantation using a strategy of preoperative plasmapheresis, intraoperative unfractionated heparin, and postoperative conversion to bivalirudin. The study details the therapeutic challenges encountered and offers an alternative approach to decrease perioperative complications, though two of the four patients experienced postoperative bleeding complications on bivalirudin. The abstract does not mention leeches, hirudin, or leech therapy; bivalirudin is discussed solely as a pharmaceutical anticoagulant. Therefore, this study has no defensible relevance to ASH's domain of hirudotherapy or the leech secretome.

Citation

Management of Heparin-Induced Thrombocytopenia Using Plasmapharesis in Patients Undergoing HeartMate 3 Left Ventricular Assist Device

Naqvi SY et al. · ASAIO journal, 2021

DOI

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

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