Management of heparin-induced thrombocytopenia during continuous renal replacement therapy

Heparin-associated thrombocytopenia occurred in a patient during continuous renal replacement therapy (CRRT), resulting in repeated clotting of the extracorporeal circuit and spontaneous hemorrhage. The peripheral platelet count initially appeared to improve by changing to prostacyclin and dalteparin. However, repeated CRRT circuit clotting recurred, and the platelet count decreased once again. This time the synthetic heparinoid, Orgaran (danaparoid), was used and was associated with successful CRRT and return of the platelet count.