What question did this study set out to answer?

The aim was to evaluate the use of argatroban as an alternative anticoagulant during cardiopulmonary bypass in patients with heparin-induced thrombocytopenia.

May 21, 2026Open Access

Use of argatroban as anticoagulation for cardiopulmonary bypass during heart transplantation: A case report

Key Points

The aim was to evaluate the use of argatroban as an alternative anticoagulant during cardiopulmonary bypass in patients with heparin-induced thrombocytopenia.
Case report of a heart transplantation with cardiopulmonary bypass.
Patient had a history of heparin-induced thrombocytopenia and prior left ventricular assist device implantation.
Argatroban was administered as the primary anticoagulant.
Anticoagulation reversal was ineffective, leading to uncontrollable coagulopathy.
Patient experienced fatal haemorrhage during the procedure.
Argatroban may be effective but requires careful consideration and further study in similar cases.

Abstract

BACKGROUND: Heparin-induced thrombocytopenia rules out the possibility of adopting heparin for cardiopulmonary bypass. To overcome this problem two anticoagulants can be used: argatroban and bivalirudin. CASE PRESENTATION: We report on the adoption of argatroban during cardiopulmonary bypass for heart transplantation in a patient affected by HIT, previously implanted with a left ventricular assist device. Despite appropriate dosing, anticoagulation reversal proved ineffective, resulting in uncontrollable coagulopathy and fatal haemorrhage. CONCLUSIONS: Argatroban could be an effective option for selected patients but more studies and particular attention are required, especially in patients with previous left ventricular assist device implantation.

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