Bivalirudin as an anticoagulation strategy for acute hemodialysis in children: Two cases with a summary of recent literature
Research article published in Hemodialysis international (2024)
Abstract
Unfractionated heparin is the most used anticoagulative agent for extracorporeal settings in children, including acute hemodialysis modalities. In certain situations, such as heparin-induced thrombocytopenia, alternatives must be applied. The direct thrombin inhibitor bivalirudin has come forth as an attractive substitute. Bivalirudin is currently only approved for adult use in specific percutaneous coronary intervention settings. However, it has a growing off-label popularity in different contexts for both adult and pediatric patients. Experience with bivalirudin in children is mainly limited to extracorporeal membrane oxygenation, ventricular assist devices and during cardiopulmonary bypass surgery. Literature about its use as anticoagulation strategy for pediatric hemodialysis is very scarce. Here, we present two pediatric cases where bivalirudin was used during acute hemodialysis, followed by a short summary of recent literature.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Bivalirudin as an anticoagulation strategy for acute hemodialysis in children: Two cases with a summary of recent literature.
Por qué esto importa para la hirudoterapia
This paper presents two pediatric case reports using bivalirudin, described in the abstract as a direct thrombin inhibitor, as an alternative anticoagulant for acute hemodialysis when unfractionated heparin is contraindicated, such as in heparin-induced thrombocytopenia, accompanied by a summary of recent literature. The abstract makes no mention of hirudin, leeches, or any relationship to hirudotherapy. Therefore, no defensible leech or ASH connection can be drawn from this abstract alone. The clinical data is limited to two cases plus a brief literature summary, serving as an anecdotal report of off-label usage rather than robust safety or efficacy evidence.
Citación
Bivalirudin as an anticoagulation strategy for acute hemodialysis in children: Two cases with a summary of recent literature
Viaene LV et al. · Hemodialysis international, 2024
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: June 18, 2026