{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T23:48:36Z","timestamp":1782085716270,"version":"3.54.5"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":51,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Thrombosis J"],"DOI":"10.1186\/s12959-026-00866-5","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:47:23Z","timestamp":1777711643000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Case report: Heparin coagulant super-sensitivity during leech therapy"],"prefix":"10.1186","volume":"24","author":[{"given":"Zhan","family":"Rong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Daniels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Luu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukasz","family":"Czerwonka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wadie F.","family":"Bahou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"issue":"4","key":"866_CR1","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/j.imr.2017.08.001","volume":"6","author":"AK Sig","year":"2017","unstructured":"Sig AK, Guney M, Uskudar Guclu A, et al. Medicinal leech therapy-an overall perspective. Integr Med Res. 2017;6(4):337\u201343.","journal-title":"Integr Med Res"},{"issue":"4","key":"866_CR2","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1067\/mva.2001.116801","volume":"34","author":"CP Cruz","year":"2001","unstructured":"Cruz CP, Eidt J, Drouilhet J, et al. Saratin, an inhibitor of von Willebrand factor-dependent platelet adhesion, decreases platelet aggregation and intimal hyperplasia in a rat carotid endarterectomy model. J Vasc Surg. 2001;34(4):724\u20139.","journal-title":"J Vasc Surg"},{"issue":"5","key":"866_CR3","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/S0092-8674(04)00172-2","volume":"116","author":"J Dai","year":"2004","unstructured":"Dai J, Liu J, Deng Y, et al. Structure and protein design of a human platelet function inhibitor. Cell. 2004;116(5):649\u201359.","journal-title":"Cell"},{"issue":"3","key":"866_CR4","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1182\/blood.V85.3.712.bloodjournal853712","volume":"85","author":"H Deckmyn","year":"1995","unstructured":"Deckmyn H, Stassen JM, Vreys I, et al. Calin from Hirudo medicinalis, an inhibitor of platelet adhesion to collagen, prevents platelet-rich thrombosis in hamsters. Blood. 1995;85(3):712\u20139.","journal-title":"Blood"},{"issue":"9","key":"866_CR5","doi-asserted-by":"publisher","first-page":"1424","DOI":"10.1161\/01.ATV.15.9.1424","volume":"15","author":"GH van Zanten","year":"1995","unstructured":"van Zanten GH, Connolly TM, Schiphorst ME, et al. Recombinant leech antiplatelet protein specifically blocks platelet deposition on collagen surfaces under flow conditions. Arterioscler Thromb Vasc Biol. 1995;15(9):1424\u201331.","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"28","key":"866_CR6","doi-asserted-by":"publisher","first-page":"16694","DOI":"10.1016\/S0021-9258(19)84761-0","volume":"264","author":"C Dunwiddie","year":"1989","unstructured":"Dunwiddie C, Thornberry NA, Bull HG, et al. Antistasin, a leech-derived inhibitor of factor Xa. Kinetic analysis of enzyme inhibition and identification of the reactive site. J Biol Chem. 1989;264(28):16694\u20139.","journal-title":"J Biol Chem"},{"key":"866_CR7","doi-asserted-by":"publisher","first-page":"660757","DOI":"10.3389\/fphar.2021.660757","volume":"12","author":"J Chen","year":"2021","unstructured":"Chen J, Cie X, Zhang H, et al. Pharmacological Activities and Mechanisms of Hirudin and Its Derivatives - A Review. Front Pharmacol. 2021;12:660757.","journal-title":"Front Pharmacol"},{"key":"866_CR8","doi-asserted-by":"crossref","unstructured":"Hackenberger P, Janis J. A comprehensive review of medicinal leeches in plastic and reconstructive surgery. Plast Reconstr Surg - Global Open. December 2019;7(12):e2555.","DOI":"10.1097\/GOX.0000000000002555"},{"issue":"9","key":"866_CR9","doi-asserted-by":"publisher","first-page":"724","DOI":"10.7326\/0003-4819-139-9-200311040-00006","volume":"139","author":"A Michalsen","year":"2003","unstructured":"Michalsen A, Klotz S, L\u00fcdtke R, et al. Effectiveness of leech therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. 2003;139(9):724\u201330.","journal-title":"Ann Intern Med"},{"key":"866_CR10","unstructured":"U.S. Food and Drug Administration, Center for Biological Evaluation and Research Brand. Product Classification. Retrieved February 25, 2025 from https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfPCD\/classification.cfm?ID=NRN"},{"key":"866_CR11","unstructured":"Medical Device Classification Product Codes - Guidance for Industry and Food and Drug Administration Staff. US, FDA. https:\/\/www.fda.gov\/regulatory-information\/search-fda-guidance-documents\/medical-device-classification-product-codes-guidance-industry-and-food-and-drug-administration-staff. Accessed on March 24th 2025."},{"key":"866_CR12","unstructured":"Pourrahimi M, Abdi M, Ghods R. Complications of leech therapy. Avicenna J Phytomed 2020 May-Jun;10(3):222\u201334."},{"key":"866_CR13","doi-asserted-by":"crossref","unstructured":"G\u00fcven R. Treatment of a patient in hemorrhagic shock due to leech bite with tranexamic acid. Am J Emerg Med. 2016;34(11):2253.e3-2253.e4.","DOI":"10.1016\/j.ajem.2016.05.021"},{"issue":"1","key":"866_CR14","first-page":"47","volume":"11","author":"UC Dolek","year":"2023","unstructured":"Dolek UC, Ozdemir S, Babayeva K, et al. Leech Application-related Upper Gastrointestinal Bleeding: A Case Report. Bull Emerg Trauma. 2023;11(1):47\u201350.","journal-title":"Bull Emerg Trauma"},{"issue":"9","key":"866_CR15","doi-asserted-by":"publisher","first-page":"e10673","DOI":"10.1016\/j.ajem.2008.03.022","volume":"26","author":"A Kose","year":"2008","unstructured":"Kose A, Zengin S, Kose B, et al. Leech bites: massive bleeding, coagulation profile disorders, and severe anemia. Am J Emerg Med. 2008;26(9):e10673\u20136.","journal-title":"Am J Emerg Med"},{"key":"866_CR16","doi-asserted-by":"publisher","first-page":"205929","DOI":"10.1155\/2014\/205929","volume":"2014","author":"KY Mumcuoglu","year":"2014","unstructured":"Mumcuoglu KY. Recommendations for the use of leeches in reconstructive plastic surgery. Evid Based Complement Alternat Med. 2014;2014:205929.","journal-title":"Evid Based Complement Alternat Med"},{"issue":"6","key":"866_CR17","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1161\/01.CIR.97.6.544","volume":"97","author":"JI Weitz","year":"1998","unstructured":"Weitz JI, Leslie B, Hudoba M. Thrombin binds to soluble fibrin degradation products where it is protected from inhibition by heparin-antithrombin but susceptible to inactivation by antithrombin-independent inhibitors. Circulation. 1998;97(6):544\u201352.","journal-title":"Circulation"},{"issue":"8","key":"866_CR18","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1001\/archotol.128.8.960","volume":"128","author":"DB Chepeha","year":"2002","unstructured":"Chepeha DB, Nussenbaum B, Bradford CR, Teknos TN. Leech Therapy for Patients With Surgically Unsalvageable Venous Obstruction After Revascularized Free Tissue Transfer. Arch Otolaryngol Head Neck Surg. 2002;128(8):960\u20135.","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"2 Suppl","key":"866_CR19","doi-asserted-by":"publisher","first-page":"eS24","DOI":"10.1378\/chest.11-2291","volume":"141","author":"DA Garcia","year":"2012","unstructured":"Garcia DA, Baglin TP, Weitz JI, Samama MM. Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):eS24\u201343.","journal-title":"Chest"},{"issue":"1","key":"866_CR20","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1097\/00006534-200201000-00034","volume":"109","author":"ML Conforti","year":"2002","unstructured":"Conforti ML, Connor NP, Heisey DM, Hartig GK. Evaluation of performance characteristics of the medicinal leech (Hirudo medicinalis) for the treatment of venous congestion. Plast Reconstr Surg. 2002;109(1):228\u201335.","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"866_CR21","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1111\/j.1365-2141.2005.05753.x","volume":"131","author":"CT Esmon","year":"2005","unstructured":"Esmon CT. The interactions between inflammation and coagulation. Br J Haematol. 2005;131(4):417\u201330. https:\/\/doi.org\/10.1111\/j.1365-2141.2005.05753.x.","journal-title":"Br J Haematol"},{"key":"866_CR22","doi-asserted-by":"crossref","unstructured":"Ungprasert P, Srivali N, Kittanamongkolchai W. Risk of venous thromboembolism in patients with Sj\u00f6gren\u2019s syndrome: a systematic review and meta-analysis. Clin Exp Rheumatol. 2015 Sep-Oct;33(5):746\u201350.","DOI":"10.4103\/0970-2113.192862"},{"issue":"1","key":"866_CR23","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/0049-3848(75)90129-2","volume":"7","author":"E Harper","year":"1975","unstructured":"Harper E, Simons ER, Chesney CM, Colman RW. The effect of chemical or enzymatic modifications upon the ability of collagen to form multimers and to initiate platelet aggregation. Thromb Res. 1975;7(1):113\u201322.","journal-title":"Thromb Res"},{"key":"866_CR24","doi-asserted-by":"publisher","first-page":"0050","DOI":"10.34133\/bdr.0050","volume":"6","author":"Z-Z Wang","year":"2024","unstructured":"Wang Z-Z, Wang K, Xu L-F, Su C, Gong J-S, Shi J-S, Ma X-D, Xie N. Qian J.-Y. Unlocking the potential of collagenases: Structures, functions, and emerging therapeutic horizons. BioDesign Res. 2024;6:0050.","journal-title":"BioDesign Res"},{"issue":"7","key":"866_CR25","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1016\/j.toxicon.2009.12.003","volume":"56","author":"IM Francischetti","year":"2010","unstructured":"Francischetti IM. Platelet aggregation inhibitors from hematophagous animals. Toxicon. 2010;56(7):1130\u201344.","journal-title":"Toxicon"},{"issue":"3","key":"866_CR26","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/j.jtcvs.2009.04.049","volume":"138","author":"S Sugimoto","year":"2009","unstructured":"Sugimoto S, Lin X, Lai J, Okazaki M, Das NA, Li W, Krupnick AS, Chen R, Jeong SS, Patterson GA, Kreisel D, Gelman AE. Apyrase treatment prevents ischemia-reperfusion injury in rat lung isografts. J Thorac Cardiovasc Surg. 2009;138(3):752\u20139.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"Suppl 1Suppl 1","key":"866_CR27","first-page":"S28","volume":"99","author":"JR Coleman","year":"2024","unstructured":"Coleman JR, Gumina R, Hund T, Cohen M, Neal MD, Townsend K, Kerlin BA. Sex dimorphisms in coagulation: Implications in trauma-induced coagulopathy and trauma resuscitation. Am J Hematol. 2024;99(Suppl 1Suppl 1):S28\u201335.","journal-title":"Am J Hematol"},{"issue":"3","key":"866_CR28","first-page":"252","volume":"10","author":"A Mousavian","year":"2022","unstructured":"Mousavian A, Sabzevari S, Parsazad S, et al. Leech Therapy Protects Free Flaps against Venous Congestion, Thrombus Formation, and Ischemia\/Reperfusion Injury: Benefits, Complications, and Contradictions. Arch Bone Jt Surg. 2022;10(3):252\u201360.","journal-title":"Arch Bone Jt Surg"}],"container-title":["Thrombosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12959-026-00866-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12959-026-00866-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12959-026-00866-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T23:43:03Z","timestamp":1782085383000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12959-026-00866-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,2]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["866"],"URL":"https:\/\/doi.org\/10.1186\/s12959-026-00866-5","relation":{},"ISSN":["1477-9560"],"issn-type":[{"value":"1477-9560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,2]]},"assertion":[{"value":"1 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Our institution does not require ethical approval for reporting individual cases or case series.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent to publish has been obtained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"58"}}