Moreno-Duarte, IngridCooter, MaryOnwuemene, Oluwatoyosi AGhadimi, KamrouzWelsby, Ian J2024-01-102024-01-102021-020042-90071423-0410https://hdl.handle.net/10161/29719<h4>Background and objectives</h4>Heparin-induced thrombocytopenia (HIT) is an antibody-mediated condition that leads to thrombocytopenia and possible thrombosis. Patients with HIT who require cardiac surgery pose a challenge as high doses of heparin or heparin alternatives are required to permit cardiopulmonary bypass (CPB). Intraoperative therapeutic plasma exchange (TPE) is a valuable adjunct in the management of antibody-mediated syndromes including HIT. The clinical impact of TPE on thromboembolic events, bleeding and mortality after heparin re-exposure is not well established. We hypothesized that TPE with heparin re-exposure will not lead to HIT-related thromboembolic events, bleeding or increased mortality after cardiac surgery with CPB.<h4>Materials and methods</h4>We reviewed 330 patients who received perioperative TPE between September 2012 and September 2017.<h4>Results</h4>Twenty four patients received TPE for HIT before anticipated heparin use for CPB. Most patients were males (79%) scheduled for advanced heart failure therapies. Three patients (12·5%) died within 30 days after surgery but none of the deaths were considered HIT-related. Thromboembolic events (TE) occurred in 3 patients within 7 days of surgery; of those, two were possibly HIT-related.<h4>Conclusion</h4>Therapeutic plasma exchange with heparin re-exposure was not strongly associated with HIT-related thrombosis/death after cardiac surgery with CPB.HumansThromboembolismThrombosisThrombocytopeniaHemorrhageHeparinAntibodiesTreatment OutcomePlasma ExchangeCardiac Surgical ProceduresCardiopulmonary BypassAgedMiddle AgedFemaleMalePerioperative PeriodJournal article