Undergoing cardiopulmonary bypass using enoxaparin only during a cardiac transplantation procedure

The use of enoxaparin as a replacement drug to standard heparin, for antico agulation during extracorporeal circulation, in patients with heparin-induc ed thrombocytopenia, is still very limited. Enoxaparin significantly reduce s thrombin formation and activity during cardiopulmonary bypass. The prolon ged circulating rate, slow elimination rate and non-total reversion of enox aparin by protamine can induce important postoperative bleeding. We are des cribing the first case of cardiac transplantation where enoxaparin was used as a replacement drug to standard heparin. (C) 2000 Elsevier Science B.V. All rights reserved.