Towards a diagnosis of heparin-induced thrombocytopenia after cardiopulmonary bypass

Abstract

In summary, Louët et al. [13] provide important information to aid us in the difficult diagnosis of HIT after CPB. A rise in the platelet count post-CPB followed by a decline after day 4 strongly suggests HIT. Prolonged thrombocytopenia after CPB, while not as predictive of HIT, must be carefully evaluated. Arterial or venous thrombosis or a positive SRA support the diagnosis and a negative anti-PF4/heparin antibody assay makes the diagnosis less likely. Unfortunately, in many patients alternative causes of thrombocytopenia cannot be excluded with certainty and laboratory testing is not timely or definitive. Nevertheless, while the diagnosis of HIT remains difficult in many patients after CPB, we now have more data on which to rely. © 2004 International Society on Thrombosis and Haemostasis.