06 April 2018 : Case report
Simultaneous Pancreas-Kidney Transplantation in a Patient with Heparin-Induced Thrombocytopenia on Dabigatran Therapy
Agnieszka Jóźwik1ABCF, Wojciech Lisik1ACD, Jarosław Czerwiński2DEF*, Maciej Kosieradzki1ABCDEDOI: 10.12659/AOT.905868
Ann Transplant 2018; 23:232-235
Abstract
BACKGROUND: New oral anticoagulants like direct thrombin inhibitors are an attractive alternative to vitamin K antagonists as anticoagulation therapy and can be used in heparin-induced thrombocytopenia. They are convenient in low-risk surgery, as there is no need for bridging with heparins. Patients who need urgent major surgery are at similar risk as on warfarin therapy, which, however, is much higher than in elective procedures. Due to their elimination profiles, these drugs are generally contraindicated in patients with severe renal insufficiency. On the other hand, pancreas transplantation is associated with high risk of bleeding and substantial risk of graft thrombosis. There are no recommendations on anticoagulation therapy in high-risk patients on kidney-pancreas waiting lists who cannot be given heparins.
CASE REPORT: We describe a case of simultaneous pancreas-kidney transplantation in a patient with heparin-induced thrombocytopenia on dabigatran treatment.
CONCLUSIONS: We conclude that, despite the high risk, pancreas transplantation in a patient with HIT can be safely done while on NOAC therapy, but an access to idarucizumab should be assured.
Keywords: Anticoagulants, Pancreas Transplantation, renal insufficiency, Thrombocytopenia
615 3
In Press
14 Sep 2023 : Case report
Intrahepatic Venous Collateral Circulation and Reverse Blood Flow After Main Hepatic Vein Obstruction: A Ca...Ann Transplant In Press; DOI: 10.12659/AOT.941521
12 Sep 2023 : Original article
Three-Dimensional Printing of Polycaprolactone/Nano-Hydroxyapatite Composite Scaffolds with a Pore Size of ...Ann Transplant In Press; DOI: 10.12659/AOT.940365
04 Sep 2023 : Original article
Analysis of Anxiety and Influencing Factors in Kidney Transplant Recipients and General Public During the C...Ann Transplant In Press; DOI: 10.12659/AOT.941489
04 Sep 2023 : Original article
Prolonged Tracheal Intubation in the ICU as a Possible Risk Factor for Arytenoid Dislocation After Liver Tr...Ann Transplant In Press; DOI: 10.12659/AOT.940727
Most Viewed Current Articles
24 Aug 2021 : Review article
Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future PerspectivesDOI :10.12659/AOT.931664
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review article
Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive ModelsDOI :10.12659/AOT.934924
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original article
Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...DOI :10.12659/AOT.933588
Ann Transplant 2021; 26:e933588
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860