Clinical outcomes of 1,478
danaparoid treatment case reports for HIT (involving 1,418 patients) treated between 1982 and mid-2004 are analysed. Treatment in 1,291 episodes was for current HIT.
Thromboembolism due to HIT was present in 39.4%. The patients include 33 children and 32 pregnancies. Two hundred twenty-six patients required extra-corporeal circuit use for
renal failure, 241 patients had a concomitant thrombophilic disorder, and 351 major operations were performed. Clinical outcomes were assessed during
danaparoid treatment (range one day to 3.5 years) plus three months of follow-up. Of the
danaparoid-treated patients 83.8% survived; 63.7% had no or minor adverse events and 20.1% suffered serious non-fatal adverse events. New
thromboses occurred during 9.7% of treatment episodes, and 16.4% of treatment episodes had an inadequate treatment response (i. e. developed one or more of the following: new/extended
thrombosis, persistent/new platelet count reduction, unplanned
amputation during treatment and follow-up). Major
bleeding was reported in 8.1% of treatment episodes. Clinical cross-reactivity of
danaparoid (new/persistent platelet count reduction and/or new/extended
thrombosis) was confirmed serologically in 23 of 36 patients with positive pretreatment serological
danaparoid cross-reactivity and in 22 of 32 additional patients tested at the time of the new event, i.e. a total of 45 patients (3.2%). Clinical outcomes of these case reports of patients given
danaparoid because of suspected or confirmed HIT appear to be comparable with those reported by others who used
direct thrombin inhibitors, especially when a sufficient
danaparoid dosing intensity was used in patients with isolated HIT. Post-operative
bleeding limits
danaparoid use for cardiopulmonary by-pass surgery. Routine clinical and platelet count monitoring are required to minimise adverse reactions due to cross-reactivity.