Anticoagulants are pivotal to achieve circulation in extracorporeal circuits. In this
review we discuss several anticoagulants in clinical use or in the preclinical phase.
In hemodialysis the low-molecular-weight heparins (LMWHs) appear to be as effective
and safe as standard heparin (SH). The main advantages of LMWHs in hemodialysis are
the efficacy of a single loading dose, and the lack of laboratory control requirements.
Newer anticoagulants such as dermatan sulfate and hirudin have been used in dosefinding
studies in hemodialysis, although long-term experience is lacking. LMW heparinoid
may be used to replace SH or LMWH in the case of heparin-induced thrombocytopenia.
In cardiopulmonary bypass surgery (CPB) heparin-coated extracorporeal circuits are
now being commonly applied. Their main advantage is the requirement of lower systemic
dosages of heparin. In CPB the place of LMWH or other anticoagulants needs to be investigated.
Low-molecular-weight heparins - heparinoids - dermatan sulfate - hirudin - pentasaccharide
- heparin-coated - extracorporeal circuits
