Pharmacy Services, Henry Ford Hospital, Detroit, Michigan, USA.
ASAIO J. 2013 Sep-Oct;59(5):526-7. doi: 10.1097/MAT.0b013e31829f0eb1.
Pentoxifylline is an agent that improves red blood cell deformability (known as a hemorrheologic effect) and reduces blood viscosity. Here, we present a case of a patient with hemolytic anemia after continuous-flow left ventricular assist device (CF-LVAD) implantation that was successfully treated with pentoxifylline. Our case is a 64-year-old African American woman who was implanted with a HeartMate II device on August 6, 2010, as a bridge to transplant for end-stage heart failure. Her postoperative course was complicated by recurrent gastrointestinal bleeding and antiplatelet therapy was discontinued. On October 25, 2011, she was readmitted with anemia and hemoglobin of 6.6 mg/dl and no identifiable source of bleeding. Her lactate dehydrogenase (LDH) was 936 IU/L, indicating severe hemolysis. Due to her evidence of hemolytic anemia and her inability to tolerate antiplatelet therapy due to recurrent bleeding, she was discharged on pentoxifylline 400 mg thrice daily on October 27, 2011, with hemoglobin of 11.2 mg/dl after transfusion. After 60 days of pentoxifylline, her hemoglobin and LDH in clinic were 10.1 mg/dl and 223 IU/L, respectively. The patient was successfully bridged to transplant in June 2012. Additional analysis of pentoxifylline as a therapeutic modality to manage hemolytic anemia after CF-LVAD implantation may be warranted.
己酮可可碱是一种改善红细胞变形性（称为血液流变学效应）和降低血液黏度的药物。在这里，我们报告了一例连续流动左心室辅助装置（CF-LVAD）植入后发生溶血性贫血的患者，该患者成功接受了己酮可可碱治疗。我们的病例是一位 64 岁的非裔美国女性，她于 2010 年 8 月 6 日植入了 HeartMate II 装置，作为终末期心力衰竭的移植桥接。她的术后过程中出现复发性胃肠道出血，并停止了抗血小板治疗。2011 年 10 月 25 日，她因贫血和血红蛋白 6.6mg/dl 再次入院，且未发现明显的出血原因。她的乳酸脱氢酶（LDH）为 936IU/L，表明严重溶血。由于她有溶血性贫血的证据，并且由于反复出血而无法耐受抗血小板治疗，因此她于 2011 年 10 月 27 日开始接受每日三次、每次 400mg 的己酮可可碱治疗，输血后血红蛋白为 11.2mg/dl。在接受己酮可可碱治疗 60 天后，她的血红蛋白和临床 LDH 分别为 10.1mg/dl 和 223IU/L。该患者于 2012 年 6 月成功桥接移植。可能需要进一步分析己酮可可碱作为 CF-LVAD 植入后治疗溶血性贫血的治疗方法。
