Hirudin and its reversal

Editor—I read the informative editorial on heparin resistanceby Anderson and Saenko¹ with interest. However, experience forcesme to point out a possible area for confusion. Currently, thereis no drug reversal available for r-hirudin and reversal ofits anticoagulant effect relies entirely on renal elimination(biological half-life of 1–1.5 h).² In patients with poorrenal function, r-hirudin has a prolonged half-life, which maylead to serious bleeding problems after cardiopulmonary bypass(CPB).³ Indeed, poor