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Heparin-Induced Thrombocytopenia (HIT) — Management
First-line
Second-line
SECOND-LINE
Suspected HIT
4T score
+ platelet drop
Immediate
After platelet recovery
Stop
Discontinue ALL heparin
including flushes / LMWH
Anticoagulate
Non-heparin anticoagulant
argatroban / bivalirudin / fondaparinux ↗
Avoid
No platelet transfusion
unless bleeding
Transition
DOAC or warfarin
overlap; treat ≥ 3 months if thrombosis