Department of General Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany.
Transpl Int. 2011 Oct;24(10):e89-92. doi: 10.1111/j.1432-2277.2011.01323.x. Epub 2011 Sep 2.
Heparin-induced thrombocytopenia (HIT) type II is caused by an immune-mediated side effect of heparin anticoagulation resulting in a clotting disorder. In the setting of urgent liver transplantation, the question arises whether a graft from a heparinized donor can be safely transplantated in a recipient with even acute heparin-induced thrombocytopenia type II. We report on a patient with end-stage liver disease and acute HIT II waiting for liver transplantation. Despite the risk of life-threatening complications, an organ procured from a heparinized donor was accepted. Assuming heparin residuals within the graft, the donor organ was flushed backtable with increased amounts of Wisconsin solution. The subsequent transplantation and the postoperative course were uneventful; neither thromboses nor graft dysfunction occurred. Even in acute episode of HIT II with circulating antibodies, a patient may receive an organ from a heparin-treated donor, if adequate precautions during organ preparation are observed.
肝素诱导的血小板减少症（HIT）Ⅱ型是由肝素抗凝的免疫介导的副作用引起的，导致凝血障碍。在紧急肝移植的情况下，问题是即使是急性肝素诱导的血小板减少症Ⅱ型患者，是否可以安全地移植来自肝素化供体的移植物。我们报告了一名患有终末期肝病和急性 HIT Ⅱ型的患者，正在等待肝移植。尽管存在危及生命的并发症的风险，但仍接受了来自肝素化供体的器官。假设移植物内存在肝素残留，供体器官在手术台上用大量威斯康星溶液冲洗。随后的移植和术后过程均未出现异常；既没有血栓形成也没有移植物功能障碍。即使在急性 HIT Ⅱ型伴有循环抗体的情况下，如果在器官准备过程中观察到足够的预防措施，患者也可以从肝素处理的供体中获得器官。
