D HIT in Bone Marrow and Solid Organ Transplantation

Given the widespread use of heparin to maintain patency of indwelling catheters, it is surprising that there are few reports of HIT in patients undergoing intensive anticancer chemotherapy. Two reports describe patients with apparent HIT complicating allogeneic or autologous marrow or stem cell transplantation (Tezcan et al., 1994; Sauer et al., 1999). Subclavian vein thrombosis occurred in one patient. It is possible that the combination of intensive chemotherapy and treatment-induced thrombocyto-penia reduces the likelihood of HIT antibody formation or clinical expression of HIT.

There is an intriguing report of a man recently recovered from HIT who was about to receive autologous marrow transplantation. When his marrow was collected into heparin anticoagulant, substantial ex vivo thrombus formation occurred, preventing adequate cell collection (Bowers and Jones, 2002).

Solid organ or tissue transplantation is rarely complicated by postoperative HIT (Hourigan et al., 2002; Anderegg et al., 2005; Rastellini et al., 2006). Whether postoperative immunosuppression reduces the risk of HIT compared with other postoperative patient populations is unknown.

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