Plasma exchange on venovenous extracorporeal membrane oxygenation with bivalirudin anticoagulation

World J Pediatr Congenit Heart Surg. 2015 Jan;6(1):119-22. doi: 10.1177/2150135114553476.

Abstract

A pediatric patient requiring venovenous (VV) extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation developed heparin-induced thrombocytopenia. Unfractionated heparin was discontinued, and a bivalirudin infusion was started. During the lung transplant evaluation, he was found to have allosensitization, requiring treatment with plasma exchange along with pulse methylprednisolone, rituximab, bortezomib, and pooled immunoglobulin infusion. We describe our experience with successful plasma exchange for allosensitization during bivalirudin anticoagulation on VV ECMO in a pediatric patient.

Keywords: bivalirudin; extracorporeal membrane oxygenation; plasma exchange; venovenous.

Publication types

  • Case Reports

MeSH terms

  • Antithrombins / therapeutic use*
  • Extracorporeal Membrane Oxygenation*
  • Fatal Outcome
  • Heparin / adverse effects
  • Hirudins
  • Humans
  • Infant
  • Lung Transplantation*
  • Male
  • Peptide Fragments / therapeutic use*
  • Plasma Exchange*
  • Preoperative Care / methods*
  • Recombinant Proteins / therapeutic use
  • Thrombocytopenia / chemically induced
  • Thrombosis / prevention & control*

Substances

  • Antithrombins
  • Hirudins
  • Peptide Fragments
  • Recombinant Proteins
  • Heparin
  • bivalirudin