Related Experiment Video
Updated: Oct 4, 2025

Isolation of Human Lymphatic Endothelial Cells by Multi-parameter Fluorescence-activated Cell Sorting
Published on: May 1, 2015
Heparin-induced thrombocytopenia and thrombosis in primary lymphedema patients who underwent vascularized lymph node
Shao-Yun Hsu1, Chia-Yu Lin1,2, Ming-Huei Cheng1,2,3,4
1Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Background:
Heparin-induced thrombocytopenia and thrombosis (HITT) may result in microsurgical flap failure. This study investigated the outcomes of HITT in primary lymphedema patients who underwent vascularized lymph node transplantations (VLNT).
Methods:
Between 2012 and 2019, primary lymphedema patients who underwent VLNTs were retrospectively included. The 4Ts score was used to categorize patients into HITT (scores of 5-7) and non-HITT (score < 5) groups. Outcome evaluations included the re-exploration rate, success rate, circumferential differences, cellulitis episodes, and Lymphedema Specific Quality of Life Questionnaire (LYMQoL) scores.
Results:
Twenty-six and 15 patients with 31 and 16 VLNTs were included in the HITT and non-HITT groups, respectively. The HITT group had significantly greater first, second and third re-exploration rates of 38.7% (12/31), 25.7% (8/31), and 6.5% (2/31) than the non-HITT group (6.3%, 0%, and 0%, all p < 0.01), respectively. The platelet counts significantly decreased by 21.0% in the HITT group compared with the non-HITT group (14%) on postoperative Day one (p < 0.01) with a cutoff value of 17% and AUC = 0.88.
Conclusions:
HITT may cause a high re-exploration rate of VLNTs in primary lymphedema patients. The 17% reduction in platelets on postoperative day one was an early sign for detecting HITT.
Related Concept Videos
Venous Thrombosis III: Interprofessional Care
Venous Thrombosis I: Introduction
Peripheral Artery Disease V: Postoperative Nursing Management
Venous Thrombosis IV: Nursing Management
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

