Smjernice Hrvatskog društva za hematologiju i transfuzijsku medicinu u dijagnostičko-terapijskom postupku za trombocitopeniju izazvanu heparinom (HIT) [Croatian Society for Haematology and Transfusion Medicine Guidelines on the diagnosis and management of heparin induced thrombocytopenia (HIT)]

Heparin induced thrombocytopenia (HIT) is a serious complication of heparin administration. In the last decade, this clinical syndrome has come into the focus of interest, primarily because of the severe thromboembolic complications that may lead to lethal outcome. In addition, great improvements have been made in the treatment with direct thrombin inhibitors and in laboratory diagnosis of HIT. As guidelines for diagnostic and management of HIT upgrade the quality of patient treatment, activities for their development have been launched in the Republic of Croatia. Based on British Committee for Standards in Haematology (BCSH) recommendations on diagnostic and treatment of HIT from 2006, activities for the introduction of new assays for anti-heparin antibodies were launched in 2008 and 2009, including algorithm of laboratory testing for HIT, sheet for clinical assessment of HIT (4T score), and education oftransfusiologists and clinicians. Upon evaluation of the results collected during one-year period, the Croatian Society of Haematology and Transfusion Medicine nominated a task force for the development of guidelines for HIT in January 2010. Following wide-ranging discussion, the guidelines were adopted in May 2011

Croatian Society for Haematology and Transfusion Medicine Guidelines on the Diagnosis and Management of Heparin Induced Thrombocytopenia (HIT)

Trombocitopenija izazvana heparinom (HIT) teška je nuspojava heparinske terapije. U posljednjih desetak godina ovaj kliničkopatološki sindrom u središtu je interesa primarno zbog teških tromboembolijskih komplikacija, koje mogu imati i smrtni ishod. Znatno poboljšanje u liječenju HIT-a, postignuto je primjenom direktnih inhibitora trombina u zamjenu za heparin, a laboratorijsko ispitivanje antiheparinskih protutijela znatno je unaprijedilo dijagnostiku HIT-a. Uvođenje smjernica za dijagnostičko-terapijski postupak za HIT ima znatan učinak na kvalitetu liječenja bolesnika. Godine 2008. u Republici Hrvatskoj (RH) pokrenut je niz aktivnosti u cilju uspostavljanja smjernica za HIT, temeljenih na britanskim preporukama za dijagnostiku i liječenje trombocitopenije izazvane heparinom iz 2006. godine. Tijekom 2008/09. godine uvedeni su novi testovi za antiheparinska protutijela, algoritam laboratorijskog ispitivanja i obrazac za kliničku procjenu HIT-a te izobrazba transfuziologa i kliničara. U siječnju 2010. godine na stručnom sastanku Hrvatskog društva za hematologiju i transfuzijsku medicinu (HDHTM), nakon evaluacije rezultata jednogodišnje primjene preporuka osnovana je radna skupina za donošenje smjernica HDHTM-a za HIT. Nakon usuglašavanja i javne rasprave smjernice su prihvaćene u svibnju 2011. godine.Heparin induced thrombocytopenia (HIT) is a serious complication of heparin administration. In the last decade, this clinical syndrome has come into the focus of interest, primarily because of the severe thromboembolic complications that may lead to lethal outcome. In addition, great improvements have been made in the treatment with direct thrombin inhibitors and in laboratory diagnosis of HIT. As guidelines for diagnostic and management of HIT upgrade the quality of patient treatment, activities for their development have been launched in the Republic of Croatia. Based on British Committee for Standards in Haematology (BCSH) recommendations on diagnostic and treatment of HIT from 2006, activities for the introduction of new assays for anti-heparin antibodies were launched in 2008 and 2009, including algorithm of laboratory testing for HIT, sheet for clinical assessment of HIT (4T score), and education of transfusiologists and clinicians. Upon evaluation of the results collected during one-year period, the Croatian Society of Haematology and Transfusion Medicine nominated a task force for the development of guidelines for HIT in January 2010. Following wide-ranging discussion, the guidelines were adopted in May 2011