Sakakibara Satoshi, Hirade Ritsuko, Mihara Toru, Ota Junichi, Nikai Tetsuro, Saito Yoji
Masui. 2014 Mar;63(3):346-9.
A 67-year-old woman with a diabetic renal failure was scheduled for a living kidney transplantation. Heparin was first used during hemodialysis 5 days before operation. Thrombocytopenia was found immediately after induction of general anesthesia, and the diagnosis of HIT was wade based on clinical symptom and 4 T's scoring. The surgery was continued because of the progress of donor surgery. Argatoroban was administered based on APTT measurement as an anticoagulation therapy during and after the operation. Although deep vein thrombosis was found 13 days after the operation, the transplanted kidney was established successfully. It is necessary to take a great caution in HIT development after heparin use.
一名67岁的糖尿病肾衰竭女性计划接受活体肾移植。术前5天血液透析时首次使用肝素。全身麻醉诱导后立即发现血小板减少，根据临床症状和4T评分做出肝素诱导的血小板减少症（HIT）的诊断。由于供体手术的进展，手术继续进行。术中及术后根据活化部分凝血活酶时间（APTT）测量给予阿加曲班作为抗凝治疗。尽管术后13天发现深静脉血栓形成，但移植肾成功植入。肝素使用后发生HIT时必须格外谨慎。
