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Heparin-induced thrombocytopenia (HIT) occurs in about 1% of patients receiving unfractionated heparin (UFH), usually after cardiovascular or orthopedic surgery. In such cases, reexposure to the anticoagulant should generally be avoided, but sometimes a patient will develop a new indication for it.
To find out whether patients with a history of HIT can be safely reexposed to UFH, investigators in Canada examined clinical and serological outcomes in 20 patients treated with heparin an average of 4.4 years (range, 8 weeks to 13.5 years) after HIT diagnosis. Of these, 17 had a perioperative exposure to UFH and 3 had a medical course of UFH or low-molecular-weight heparin lasting up to 17 days. The first episode of HIT was confirmed in all patie…