Abstract

HEPARIN INDUCED THROMBOCYTOPENIA AND HEMODIALYSIS

Amal S. Elhassade*, Mukul Tailang and Ahlam Mohamed Ben Naser

Abstract

Unfractionated heparin is the most commonly used anticoagulant for hemodialysis (HD). It is well-known that heparin can cause immunemediated thrombocytopenia due to immunoglobulin antibody formation against the complex of platelet factor 4 (PF4) and heparin. Heparin may also contribute to HD-associated platelet activation, thrombocytopenia and increased PF4 release from platelets during a heparin dialytic session. The present study was conducted to study the effect of unfractionated heparin as anticoagulant agent in newly treatment of hemodialysis patients. Material and method: Samples from 72 persons were selected. Out of which 32 patients were on dialysis for first time in Alwahda teaching hospital, Derna-Libya and at the same time a group of 40 healthy adults were randomly selected to participate in the study as control. Platelets from all the patients on dialysis before starting heparin treatment and one month after heparin treatment were estimated by Automated cell counter (Sysmex X 21). Result: The mean platelet value in patients after the treatment with heparin was significantly lower (192.3 ± 20.7) × 109/l than the non-treated group (203 ± 20.7 × 109/l) (P = 0.001). Conclusion: Present studies reveal that heparin, as anti-coagulant agent, significantly decreases platelet count without producing thrombocytopenia.

Keywords: Thrombocytopenia, PF4, immunoglobulin.