Case 102 | Clinical Pathology Unknown Conference

1. Prepared by Rebecca Wingfield, MD and reviewed by Lorraine N. Blagg, MA, MLS(ASCP)SBB

Clinical Vignette:
An adult patient with history of recurrent deep vein thrombosis/pulmonary embolism (DVT/PE) and orthotopic heart transplant was found to have moderate cellular rejection on routine follow up biopsy. Immunogenetics antibody screen revealed new HLA donor specific antibodies (DSA). Patient was admitted to the hospital and started on IV steroids. A repeat biopsy one week later revealed mild cellular rejection and newly identified antibody-mediated rejection. The apheresis team was consulted and the decision was made to start the patient on therapeutic plasma exchange.

The patient's home apixaban dose, which was prescribed for history of recurrent DVT/PE, was continued during hospitalization. The primary care team has concerns about maintaining adequate anticoagulation and reaches out to the apheresis team to coordinate anticoagulant administration with the therapeutic plasma exchange procedure.

Question:
What recommendation should be made to the clinical team regarding timing of apixaban administration?

Administer Apixaban pre-procedure.

Administer Apixaban during the procedure.

Administer Apixaban post-procedure.

Hold Apixaban therapy.

14 thoughts on “Case 102”

I have been absent for a while, but now I remember why I used to love this web site. Thanks , I will try and check back more often. How frequently you update your site?

Very good written article. It will be beneficial to everyone who employess it, including yours truly :). Keep doing what you are doing – can’r wait to read more posts.

You’re so awesome! I don’t believe I have read a single thing like that before. So great to find someone with some original thoughts on this topic. Really.. thank you for starting this up. This website is something that is needed on the internet, someone with a little originality!

Tech

But wanna say that this really is quite helpful Thanks for taking your time to write this.

Very well presented. Every quote was awesome and thanks for sharing the content. Keep sharing and keep motivating others.

WOW! this article it really great i like it

Hey, i found a great site with so many games
Just click this >>> DetikToto <<<

This is my first time pay a quick visit at here and i am really happy to read everthing at one place

I do not even understand how I ended up here but I assumed this publish used to be great Watch bbcfarsi news

You re so awesome! I don t believe I have read a single thing like that before.

I really like reading through a post that can make men and women think. Also thank you for allowing me to comment!

This is really interesting You re a very skilled blogger. I ve joined your feed and look forward to seeking more of your magnificent post.

Hi there to all for the reason that I am genuinely keen of reading this website s post to be updated on a regular basis. It carries pleasant stuff.

This was beautiful Admin. Thank you for your reflections.

14 thoughts on “Case 102”

Leave a Reply