Abdul Mannan: Evidence-Based Anticoagulation Strategies for Children With VTE
Abdul Mannan, Consultant Hematologist at Betsi Cadwaladr University Health Board, shared a post on LinkedIn:
“Most pediatric thrombosis guidelines were written by adults.
Literally. They were extrapolated from adult data. For decades.
That just changed.
The ASH/ISTH 2024 Paediatric VTE Guidelines dropped in Blood Advances (May 2025).
First ever joint guidelines built specifically on paediatric evidence.
And some of it will surprise you:
- For a first provoked DVT in a child?
6 weeks of anticoagulation may be enough.
Not 3 months. Not 6 months. Six. Weeks.
(If the trigger is gone and risk is low)
- DOACs are now endorsed for children.
Rivaroxaban and dabigatran both have age-appropriate approvals.
- Weight-based dosing.
- Oral.
- No INR checks.
Kids don’t have to live on warfarin anymore.
- That CVAD clot you found on imaging?
If the line is working and the child is stable — you probably don’t need to remove it.
Anticoagulate. Keep the line. Reassess.
- Unsuspected PE in a child?
Treat it. Even if they look fine.
Silent doesn’t mean harmless.
The old ‘just use the adult dose and adjust’ era is over.
These guidelines represent real paediatric trial data — Diversity, Kids-DOTT, EINSTEIN-Jr, KIDS-DOTT. Proper evidence. Proper patients.
I built a free interactive clinical reference tool based on these guidelines — all 20 recommendations, evidence summaries, drug dosing tables, and decision support. No login. No paywall.
Bookmark it. Share it with your paediatric colleagues.
What surprises you most — the 6-week duration or DOACs in kids?”
More posts from Abdul Mannan on Hemostasis Today.
-
Jul 13, 2026, 17:39Pascal Boulanger: Send a Postcard to Your Lab Staff From ISTH 2026
-
Jul 13, 2026, 17:21Stefano Navarro: Presenting Our Recently Published Article at ISTH 2026
-
Jul 13, 2026, 17:12Santagata Davide: A Great Session and an Incredible Opportunity to Present Our Research at ISTH 2026
-
Jul 13, 2026, 16:26Real-World Data Across Time Reveal Important Advances in Hemophilia Treatment – ATHN
-
Jul 13, 2026, 16:19Mary Cushman: Celebrating Our Incredible ISTH Council Members in Paris
-
Jul 13, 2026, 16:17Wolfgang Miesbach: Gene Therapy Shows Promising Early Results in Adolescents With Hemophilia B at ISTH 2026
-
Jul 13, 2026, 16:06Dino Mehic: Honored to Receive the ISTH Early Career Top Reviewer Awards
-
Jul 13, 2026, 16:01Advancing DIC Diagnosis in Cirrhosis Through Disease-Specific Risk Stratification – JTH
-
Jul 13, 2026, 15:52Joshua Muia: Presenting Our Research on ADAMTS13/VWF Dysregulation in Sepsis at ISTH 2026