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Repeat HPF4 also positive 28/4/22. High risk surgery. Ideally surgery should be delayed till plat >150 and HPF4 is negative. IF need for surgery then either single session of plasmapheresis should be done 1 day prior to surgery, if clinicaly stable then IVIG is another option. Only give heparin during surgery (DON'T give any heparin doses or flushes before surgery). Restart on fondaparinux pre and post surgery (continue till 4 weeks). NO Platelets transfusion.
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