The antithrombotic efficacy of dextran.

Dextran was introduced as early as 1944 as a plasma substitute. Since 1962 dextran has also proved to be effective as a prophylactic agent against postoperative thrombo-embolism. In general surgery low-dose heparin (LDH) is more effective in preventing isotopic deep-vein thrombosis diagnosed by the radioactive fibrinogen test, but in orthopaedic surgery dextran is superior to heparin. Dextran seems equally effective as LDH in preventing fatal pulmonary embolism both in general and orthopaedic surgery. In routine surgery, infusion of 500-1,000 ml of dextran will replace the first blood loss of 500-800 ml without risk of transmitting diseases. Simultaneously thrombo-embolic prophylaxis will be achieved with a decreased risk of haemorrhagic complications than is seen with heparin prophylaxis. The risk for severe anaphylaxis to dextran is minimal today (approx. 1 case in every 40,000 treated patients) thanks to hapten inhibition.