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. 2021 Feb 15;7(4):FSO689.
doi: 10.2144/fsoa-2020-0186.

Idarucizumab (Praxbind®) for dabigatran reversal in patients undergoing heart transplantation: a cohort of ten patients

Eran Kalmanovich  1 , Pascal Battistella  1 , Philippe Rouviere  2 , Bernard Albat  2 , Jean-Marc Frapier  2 , Roland Demaria  2 , Fabien Huet  1 , Audrey Agullo  1   2 , Marc Mourad  3 , Pascal Colson  3 , Florence Leclercq  1 , Philippe Gaudard  3 , François Roubille  1   4
Affiliations

Idarucizumab (Praxbind®) for dabigatran reversal in patients undergoing heart transplantation: a cohort of ten patients

Eran Kalmanovich et al. Future Sci OA. .

Abstract

Background: Novel oral anticoagulants are used in atrial fibrillation. Idarucizumab has been approved for reversal of dabigatran in situations of life-threatening hemorrhage or emergency surgery.

Objectives: We report a single center experience of ten patients on dabigatran therapy who were given idarucizumab prior to heart transplantation.

Methods & results: The mean plasma concentration of dabigatran prior to reversal was 139 ± 89 ng/ml. Hemoglobin, hematocrit and platelet levels were decreased after surgery. Surgical procedures were successfully performed with no increased risk, especially regarding bleeding complications. All patients were alive after 90 days.

Conclusion: Dabigatran reversal with idarucizumab in contexts of emergency surgery/urgent procedures is an attractive and safe option to be taken into consideration for patients with end stage heart disease awaiting transplantation and indication of anticoagulant therapy.

Keywords: direct oral anticoagulant (DOAC) dabigatran; heart transplantation; idarucizumab.

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Conflict of interest statement

Financial & competing interests disclosure F Roubille and F Leclercq declare to have received honoraria for lectures from Boehringer-Ingelheim. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Medical writing support was provided by B Herve and was funded by Boehringer-Ingelheim.

Figures

Figure 1.
Figure 1.. Comparison of packed red blood cell use.
Distribution and mean use of pRBC between the different cohort groups. pRBC: Packed red blood cell; VKA: Vitamin K antagonist.
See this image and copyright information in PMC

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