Extracorporeal immunoadsorption in heparin- and protamine-induced thrombocytopaenia prior to cardiac surgery

Exposure to heparin and protamine during cardiac surgery on cardiopulmonary bypass (CPB) may trigger heparin-induced thrombocytopaenia and/or protamine-induced thrombocytopaenia. Further surgery on CPB with heparin and protamine in the presence of these antibodies implies increased thromboembolic risk. We present the successful application of extracorporeal immunoadsorption to deplete antibodies causing heparin-induced and protamine-induced thrombocytopaenia preoperatively.