The “Unfraction” Reaction
An 8-year-old boy with congenital heart disease is admitted to the hospital for a planned mitral valve repair and revision. The patient has had multiple admissions to the hospital for surgery and complications relating to the congenital heart condition, most recently 1 month ago, and has required support with multiple transfusions of blood products over the years. His prior blood bank tests show that he is group A-positive with a negative antibody screen. A type and screen sample (ethylenediaminetetraacetic acid [EDTA] anticoagulant) is submitted to the blood bank along with a request for crossmatch of two units of red blood cells (RBCs).
KeywordsArgatroban Heparin-induced thrombocytopenia (HIT) Low molecular weight heparin Platelet factor 4 PF4-heparin complex Serotonin release assay 4T scoring system Unfractionated heparin