"As a result, the most common source for heparin is pig intestinal tissue, with the vast majority of the world's supply coming from China."Ĭhina is responsible for 80% of the global crude heparin supply and 50% of the world's pig population. "There was concern about using medications derived from cows, so there was a big push to move towards heparin derived from pigs," Dr. Historically, cow lung tissue was used until a bovine spongiform encephalopathy (mad cow disease) outbreak in the 1990s. Manufacturers source heparin from animal tissue. Repeating History: Examining the Heparin Shortage Due to Swine Flu Surgeons also use protamine in the OR to control heparin's effects after cardiac surgery When patients have acute bleeding problems, clinicians can give them protamine to "turn off" the heparin. Antidote availability: Protamine sulfate is an intravenous drug that reverses the effects of heparin.Surgeons use it because they can turn it off if there is a bleeding event or a patient needs to be rushed to the operating room (OR) When clinicians turn off a heparin infusion, the body breaks it down quickly and its effects wear off quickly. Short half-life: Doctors can administer unfractionated heparin up to an hour before surgery.Langer attributes unfractionated heparin's widespread use to its: "Unfractionated heparin is the workhorse."ĭr. "Unfractionated heparin is just the bulk, whereas low-molecular weight heparin is a grouping or isolation of the low-molecular weight heparin molecules," says Dr. Heparin comes in two main forms: unfractionated heparin (UFH) and low-molecular weight heparin (LMWH). Deep vein thrombosis (DVT) prophylaxis in an inpatient setting.Clot prevention during cardiac procedures, dialysis and blood transfusions.Blood clot reduction in patients with blood vessel, heart and lung conditions.As an anticoagulant, its many indications include: We already have a good system in place." Heparin's Critical Role in the Clinical SettingĬlinicians prescribe heparin to 10 to 12 million people annually. "We've made significant changes to protect those patients whose care would be compromised without heparin. "If it were to get worse, in theory, we would have to cancel elective cardiac surgeries," says surgeon Nathaniel Langer, MD, MSc, of the Cardiac Surgery Division at Mass General. The heparin working group is a subset of Mass General's larger emergency preparedness team.Įrror: Please enter a valid email address.Īt Mass General and in hospitals worldwide, the stakes are high. Heparin stakeholders, including leaders from cardiac surgery, perfusion, hematology and dialysis comprise the hospital-wide working group. Massachusetts General Hospital activated its Hospital Incident Command System to proactively prepare for the threat, adjusting key heparin protocols and examining the use of safe unfractionated heparin alternativesįacing a global heparin shortage resulting from an outbreak of African swine fever in China, Massachusetts General Hospital leaders have come together to proactively mitigate harm and reduce hospital and patient impacts.August 2018's African swine fever outbreak decimated China's pig population China is responsible for 80% of the global crude heparin supply.The popular anticoagulant heparin-derived from pig intestinal tissue-plays a critical role in cardiac surgery and other procedures requiring blood clot prevention and reduction.
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