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regional heparinization, 466 Hemofiltration. See also Hemodialysis in HIT

anticoagulation for HF using argatroban, 392 anticoagulation for HF using bivalirudin, 4i5 anticoagulation for HF using danaparoid, 329-330, 348 HF for bivalirudin elimination, 4i9,

429, 493 HF for danaparoid elimination, 468

[Hemofiltration]

HF for lepirudin elimination, 292, 352, 369, 473 Hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, 331 Hemorrhage is not a manifestation of

HIT, 34-35, 187, 284 Hemostasis, endothelium in, 210-211 Heparan sulfate, 150, 170, 176, 211, 218, 287, 319-320. See also Danaparoid (Orgaran®) Heparan sulfate-type proteoglycans (HSPGs) expression and anticoagulant function of, 211

Heparin commercial low molecular weight, characteristics, 174 danaparoid and, disaccharide structure, comparison, 320 disaccharide unit of, 168 discontinuation of, 11-12, 34, 37, 87,

90, 284, 288, 295, 465, 509 discovery and first clinical use of, 1 heparin dose-dependence in, 69, 85-86

heparin-coated devices, 30, 83-84,

95, 465, 509 heparin-induced skin lesions at subcutaneous injection sites, 45-47

immune response to heparin, 28,

132-138, 156-159 incidental heparin exposure, sensitization by, 28-29, 79, 82-83

nonspecific role of, 151-152, 228 pentasaccharide sequence of, 168-169

167-172, 211-216 platelet count monitoring in patients receiving,

32, 47, 85, 100-102 recovery following discontinuation of heparin, 32

platelet-related prohemorrhagic effects of, 120

[Heparin] platelet binding to, 117-119. See also Nonimmune heparin-platelet interactions reexposure of HIT patient to, 5, 21-22, 25, 29, 284, 298-299. See also Rapid onset of HIT repeat use, in a patient with a history of HIT, 28, 495-497 resistance, 4, 50, 264, 265, 267 structure of, 168-169 thrombosis caused by, 1-3 transforming PF4 into an alloantigen, 132-136 treatment, skin lesions associated with, 47-48 use for CPB in patients with a remote history of HIT, 299-300, 399, 476, 495-497 Heparin-associated thrombocytopenia (HAT)-1, -2, and -3, 353-356. See also Lepirudin for HIT treatment Heparin-dependent antigens enzyme immunoassay for, 140-141 role in immune heparin-induced thrombocytopenia, 131-147. See also Immune HIT Heparin-independent platelet activation, 29,121,171, 217, 237-238, 334 Heparin-induced thrombocytopenia/ thrombosis syndrome (HITTS), 12, 35, 385 Heparin-induced platelet activation (HIPA) test, 227-238, 240, 245, 253, 354 Heparin-induced thrombocytopenia (HIT) definition of, 247-249 history, 1-18

isolated HIT, 11-13,35-37,87-91,101, 284,295-296,325,328,351, 353, 358-364, 449, 453, 523 reducing the risk of, 13-15,

524-525 risk factors for, 50 Heparinization for CPB

platelet inhibition as a strategy to permit, 494-495

Hexuronic acid composition, 150,152 Hibor®, 174

Hirudin. See also Lepirudin for HIT treatment and its derivatives, 345-378 chemistry, 345 pharmacology, 345-346 pharmacokinetics, 346-347 tests for monitoring anticoagulation, 347-350 overdosage, treatment, 292,

352-353, 473 recombinant hirudin (r-hirudin), 468, 472 anticoagulation in HD, 468 elimination of, 472 pharmacokinetics of, 472 Hirulog Early Reperfusion/Occlusion

(HERO), 423 HIT antibody seroconversion, 22-25, 253

population-based studies of, 91-100 Human leukocyte antigens (HLA), 158

anti-HLA alloantibodies, 237 Hypercoagulable state, of HIT, 5,12, 35, 39, 213, 283, 305, 442, 509, 520

Hypercoagulable state, of non-HIT disorders, 42-44, 399, 466

Iceberg model of HIT, 34, 92, 97, 100, front cover Immune HIT frequency of, 69-86 heparin-dependent antigens role in,

131-147 therapy of, 286-299. See also Treatment of HIT Immune response to heparin, 28, 156-159. See also Heparin; Platelet factor 4 anamnestic immune response in HIT, 21-22, 26-27, 159, 495, 520

Immune vascular injury in HIT, 209-225

endothelium in hemostasis, 210-211

[Immune vascular injury in HIT] monocyte activation in

HIT-associated thrombosis, 217-218

Immunoglobulin G agonists and platelet activation, 190-192 In vitro cross-reactivity, 251-253. See also Danaparoid (Orgaran®) cross-reactivity using activation assays, 251-253 c-PRP versus washed platelet assays, 253 using antigen assays, 253 Innohep®, 174

Intensive care unit. See Frequency of HIT

International normalized ratio (INR), 43, 44

differential effects of DTIs on prolonging INR, 414 prolongation by argatroban, 293,

382, 393-395, 414 supratherapeutic INR and coumarin-induced venous limb gangrene, 11, 39-42, 263-265, 275 Intraoperative anticoagulation management in patients with HIT, undergoing cardiovascular surgery,

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