{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:43:21Z","timestamp":1792701801324,"version":"4.5.0"},"reference-count":54,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Heparin-induced thrombocytopenia (HIT) is a life- and limb-threatening immune-mediated emergency classically associated with heparin therapy. This review focuses on type II HIT, characterized by the development of antibodies against platelet-factor 4 (PF4) bound to heparin after exposure, causing life-threatening thrombocytopenia, arterial thrombosis, and\/or venous thrombosis. The high morbidity and mortality rates emphasize the need for early recognition and urgent intervention with discontinuation of heparin and initiation of non-heparin anticoagulation. We discuss the management of HIT with an emphasis on recent developments: (i) incorporating the phases of HIT (i.e., suspected, acute, subacute A and B, and remote) into its management, categorized according to platelet count, immunoassay, and functional assay results and (ii) direct-acting oral anticoagulants (DOACs), which are increasingly used in appropriate cases of acute HIT (off-label). In comparison to parenteral options (e.g., bivalirudin and danaparoid), they are easier to administer, are more cost-effective, and obviate the need for transition to an oral anticoagulant after platelet recovery. We also identify the knowledge gaps and suggest areas for future research.<\/jats:p>","DOI":"10.3390\/jcm13164686","type":"journal-article","created":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T06:25:24Z","timestamp":1723271124000},"page":"4686","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Management of Heparin-Induced Thrombocytopenia: A Contemporary Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7995-4696","authenticated-orcid":false,"given":"Jun Yen","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Hematology, Canberra Hospital, Canberra 2605, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"D\u2019Souza","sequence":"additional","affiliation":[{"name":"Department of Hematology, Canberra Hospital, Canberra 2605, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felanita","family":"Hutani","sequence":"additional","affiliation":[{"name":"Department of Hematology, Canberra Hospital, Canberra 2605, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9340-8125","authenticated-orcid":false,"given":"Philip","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Hematology, Canberra Hospital, Canberra 2605, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1002\/ajh.2830450312","article-title":"Pentosan polysulfate-induced thrombocytopenia and thrombosis","volume":"45","author":"Tardy","year":"1994","journal-title":"Am. 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