High incidence of anti-heparin/platelet factor 4 antibodies after cardiopulmonary bypass surgery

Fifty-one patients undergoing cardiopulmonary bypass (CPB) were studied on day 0 and day 8 for heparin-induced thrombocytopenia (HIT). The platelet aggregation test (PAT) and tests for anti-heparin-platelet factor 4 (anti-H.PF4), anti-IL8 and anti-neutrophil activating peptide 2 (anti-NAP2) antibodies (Ab) were performed by ELISA. On day 8, 27% of patients were positive for anti-H.PF4Ab. None of these results were found to influence thrombotic complications or platelet counts after CPB. Our results suggest that IgG to H.PF4 may be considered a risk factor, but that additional factors must be required for HIT to develop. We conclude that assays based on platelet activation would be more appropriate for the diagnosis of HIT after CPB.