Publication

Bivalirudin is inferior to heparin in preservation of intraoperative autologous blood

Huet, R. C. G. G., Cernak, V., de Vries, A. J. & Lisman, T., Aug-2012, In : Thrombosis Research. 130, 2, p. 163-165 3 p.

Research output: Contribution to journalArticleAcademicpeer-review

Introduction: Bivalirudin is used as an alternative to heparin in cardiac surgery, and may be superior to heparin with regard to platelet function. Bivalirudin however, is prone to cleavage by thrombin resulting in coagulation in areas of stasis.

Material and Methods: We compared the preservation of platelet function and the quality of anticoagulation in autologous blood of 26 cardiac surgical patients collected intraoperatively and anticoagulated ex vivo with either bivalirudin or heparin, with supplementation of bivalirudin over time and prevention of stasis.

Results: We found in both preservatives a reduction in ADP-induced platelet aggregation response over a period of 105 minutes (median, IQR: 73-141) as measured by Multiplate (R). Supplementation of additional bivalirudin (23 +/- 1.1 mu g/ml/hr) and prevention of stasis was not able to prevent thrombin generation. We found a 5-fold increase in levels of prothrombin fragment 1 + 2 in bivalirudin preserved autologous blood as compared to heparin preserved blood (F1+2 levels median 8.9 nM [quartile percentiles 4.2-12.4] vs 1.3 nM [0.6-2.1], P = 0.001 Mann-Whitney, n = 10).

Conclusions: Our study suggests that preservation of platelet function in autologous blood anticoagulated with bivalirudin is not a suitable alternative to heparin. (C) 2011 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)163-165
Number of pages3
JournalThrombosis Research
Volume130
Issue number2
Publication statusPublished - Aug-2012

    Keywords

  • platelets, cardiopulmonary bypass, blood anticoagulation, INDUCED THROMBOCYTOPENIA, CARDIAC-SURGERY, UNFRACTIONATED HEPARIN, CARDIOPULMONARY BYPASS, PLATELET-AGGREGATION, TISSUE FACTOR, IN-VITRO, THROMBIN, ANTICOAGULATION, INHIBITION

View graph of relations

ID: 5624110