Treatment of Heparin‐Induced Thrombocytopenia in the Setting of Venoarterial Extracorporeal Membrane Oxygenation as a Bridge to Orthotopic Heart Transplant

Heparin‐induced thrombocytopenia (HIT) is a highly impactful prothrombotic condition produced by antibody formation after heparin administration, which leads to platelet activation and both thrombocytopenia and paradoxical thrombosis. HIT has a relatively high mortality rate and greatly complicates anticoagulation strategy in patients requiring surgeries necessitating cardiopulmonary bypass, such as orthotopic heart transplant (OHT). Here, we present a small case report involving two patients who developed HIT in the setting of ongoing venoarterial extracorporeal membrane oxygenation (VA‐ECMO) support for cardiogenic shock while being listed for OHT and the novel plasma exchange strategy that was utilized to manage their HIT through the transplant process.