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This study investigated the outcomes of HITT in primary lymphedema patients who underwent vascularized lymph node transplantations (VLNT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2012 and 2019, primary lymphedema patients who underwent VLNTs were retrospectively included. The 4Ts score was used to categorize patients into HITT (scores of 5\u20137) and non\u2010HITT (score\u2009&lt;\u20095) groups. Outcome evaluations included the re\u2010exploration rate, success rate, circumferential differences, cellulitis episodes, and Lymphedema Specific Quality of Life Questionnaire (LYMQoL) scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010six and 15 patients with 31 and 16 VLNTs were included in the HITT and non\u2010HITT groups, respectively. The HITT group had significantly greater first, second and third re\u2010exploration rates of 38.7% (12\/31), 25.7% (8\/31), and 6.5% (2\/31) than the non\u2010HITT group (6.3%, 0%, and 0%, all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), respectively. The platelet counts significantly decreased by 21.0% in the HITT group compared with the non\u2010HITT group (14%) on postoperative Day one (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) with a cutoff value of 17% and AUC\u2009=\u20090.88.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HITT may cause a high re\u2010exploration rate of VLNTs in primary lymphedema patients. The 17% reduction in platelets on postoperative day one was an early sign for detecting HITT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26811","type":"journal-article","created":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T14:17:43Z","timestamp":1643811463000},"page":"958-967","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Heparin\u2010induced thrombocytopenia and thrombosis in primary lymphedema patients who underwent vascularized lymph node transplantations"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1054-9166","authenticated-orcid":false,"given":"Shao\u2010Yun","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital Taoyuan 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