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Updated: Mar 24, 2026

Percutaneous Hepatic Perfusion PHP with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
Published on: July 31, 2016
[Perioperative heparin bridging is rarely indicated]
Jørn Dalsgaard Nielsen1, Anna-Marie Bloch Münster, Steen Elkjær Husted
1jdn@dadlnet.dk.
Abstract:
Meta-analyses of cohort studies and a recent randomized, placebo-controlled study have shown that perioperative bridging of warfarin therapy with therapeutic doses of heparin results in a multi-fold increase in major bleeding but no reduction in the incidence of thromboembolism. It is time to reconsider heparin bridging: When is heparin bridging superfluous? When is prophylactic dosage indicated? And when is it safe to use therapeutic dosing?
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