Source: DGNews | Posted 9 years ago
Dialyzers May Remove Heparin Antibodies and Reduce Occurrence of Severe Thrombocytopenia
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By Danny Kucharsky
COPENHAGEN, DENMARK -- July 19, 2002 -- An "astonishingly" high number of patients on renal replacement therapy have a positive test for heparin induced thrombocytopenia (HIT II) despite the fact only a few patients show typical clinical signs, concludes a study presented at the XXXIX Congress of the European Renal Association - European Dialysis and Transplant Association.
Dr. Goetz Nowak of the medical faculty of the Friedrich Schiller University in Jena, Germany, noted that renal replacement therapy through the use of chronic intermittent haemodialysis is only possible when a high dose of heparin is administered to patients prior to each haemodialysis. While this suggests a high risk for HIT II in these patients, previous research has found less than 1.8 percent of severe cases of HIT II in these patients.
Dr. Nowak outlined a comprehensive diagnostic study of HIT II antibodies in haemodialysis patients who had been treated with heparin for a lengthy period.
The researchers performed a 14C serotonin release assay (SRA) as a diagnostic test on 236 patients from three German dialysis centres. Blood was taken before and after haemodialysis and serum was frozen and tested for antibodies within a six-week period.
To the surprise of Dr. Nowak and his colleagues, half of the patients showed antibodies in SRA. More than 80 percent of these patients had a positive result before haemodialysis, but were negative after haemodialysis. Of the remainder, 11 percent had a positive antibody test before and after haemodialysis, while nine percent were positive only at the end of haemodialysis.
Dr. Nowak found through in vitro testing that the polymer surface of the dialyzer removes HIT II antibodies and activated platelets used for haemodialysis cause a regulation of HIT II antibodies. This, in turn, tends to protect patients against generalised severe thrombocytopenia.
He concludes that the capillary dialyzers regulate HIT II antibodies and are an important preventive measure against severe thrombocytopenia with thrombotic reactions.
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