We have received with thanks a comment from our reader:
"Heparin is a wonderful drug of course, however problems with Heparin Induced Thrombocytopenia, overanticoagulation with bleeding and clotting due to underanticoagulation exist. The main issue is that one size or dose in this case does not fit all and dosing of heparin ought to be guided by aCT monitoring. But this is expensive and beyond the reach of most stand alone centres. Another alternative is to use low molecular weight heparins, but only the porcine versions have predictable dose responses. Other alternatives exist but are not readily available in the country.....Yudi"
Yes Yudi we agree with you that low molecular weight heparin is a much better alternative, unless and until someone introduce the bovine version and at a affordable price, we have no choice but to do with what we have.....MalaysianKidneySPA
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