Suppressive Effect of Dextran on Platelet Adhesiveness^[*]

Summary

43 normal volunteers, 3 patients with thrombophlebitis, and 1 patient with a high platelet adhesiveness and a history of thrombophlebitis have received dextran and its action on the mechanism of haemostasis has been studied. Platelet adhesiveness has been investigated by a slight modification of Hellem’s methods for whole blood and plasma. Dextran with a mean molecular weight of 70,000 produced a markedly lowered platelet adhesiveness together with a moderate prolongation of the Ivy bleeding time. Factor VIII was decreased by about 50% and factor V, factor IX and fibrinogen were decreased slightly more than could be expected from haemodilution alone. No fibrinolysis occurred. Dextran of lower molecular size was less potent. The possible use of dextrans as a thrombosis prophylactic agent is discussed.

• References

• 1 Bergeritz S. E, Eiken O, Nilsson I. M. The effect of dextran of various molecular weight on the coagulation in dogs. Thrombos. Diathes. haemorrh. (Stuttg.) 6: 15 1961;
• 2 Bloom W. L, Fowler N. O, Ward J. A, Franch R. H. Hemodilution and changes in hemostasis induced by dextran. An experiment in dogs with and without plasma volume expansion. J. surg. Res 3: 152 1963;
• 3 Bloom W. L, Harmer D. S, Bryant M. F, Brewer S. S. Coating of vascular surfaces and cells: new concept in prevention of intravascular thrombosis. Proc. Soc. exp. Biol. (N.Y.) 115: 384 1964;
• 4 Borgström S, Gelin L. E, Zederfeldt B. The formation of vein thrombi following tissue injury; and experimental study in rabbits. Acta chir. scand. suppl. 247 1959
• 5 Bryant M. F, Bloom W. L, Brewer S. S. Experimental study of the antithrombotic properties of dextrans of low molecular weight. Amer. Surg 29: 256 1963;
• 6 Carbone J. V, Furth Jr. F. W, Scott R, Crosby W. H. An haemostatic defect associated with dextran infusion. Proc. Soc. exp. Biol. (N. Y.) 85: 101 1954;
• 7 Chadduck W. M, Crutchfield W. G, Roberts M. Use of dextran for prevention of thrombosis in arterial segments obstructed with gradual occlusion clamps. Surg. Gynec. Obstet 121: 491 1965;
• 8 Cox E. F, Flotte G. T, Buxton R. W. Dextran in the treatment of thrombophlebitis. Surgery 57: 225 1965;
• 9 Cronberg S. Unpublished.
• 10 Cronberg S, Nilsson I. M, Silwer J. Studies on the platelet adhesiveness in von Wille-brand’s disease. Acta med. scand 180: 43 1966;
• 11 Ernst C. B, Fry W. J, Kraft R. O, de Weese M. S. The role of low molecular weight dextran in the management of venous thrombosis. Surg. Gynec. Obstet 119: 1243 1964;
• 12 Ewald R. A, Eichelberger Jr. J. W, Young A. A, Weiss H. J, Crosby W. H. The effect of dextran on platelet factor 3 activity: in vitro and in vivo studies. Transfusion 5: 109 1965;
• 13 Garzon A. A, Fink L. H, Shaftan G. W, Karlson K. E. Blood loss associated with administration of low molecular weight dextran. J. thorac. cardiovasc. Surg 48: 873 1964;
• 14 Gelin L. E, Korsan-Bengtsen K, Ygge J, Zederfeldt B. Influence of low viscous dextran on the hemostatic mechanism. Acta chir. scand 122: 324 1961;
• 15 Howard J. M, Teng G. T, Loeffler R. K. Studies of dextran of various molecular sizes. Ann. Surg 143: 369 1956;
• 16 Jacobaeus U. The effect of dextran on the coagulation of blood. Acta med. scand 151: 505 1955;
• 17 Just-Viera J. O, Yeager G. H. Protection from thrombosis in large beins. Surg. Gynec. Obstet 118: 354 1964;
• 18 Koekenberg L. J. L. Experimental use of macrodex as a prophylaxis against post-operative thrombo-embolism. Bull. Soc. int. Chir 21: 501 1962;
• 19 Langdell R. D, Adelson E, Furth F. W, Crosby W. H. Dextran and prolonged bleeding time. J. Amer. med. Ass 166: 346 1958;
• 20 Moncrief J. A, Darin J. G, Canizaro P. G, Sawyer R. B. Use of dextran to prevent arterial and venous thrombosis. Ann. Surg 158: 553 1963;
• 21 Niléhn J.-E, Nilsson I. M. Demonstration of fibrinolytic split products in human serum by an immunological method in spontaneous and induced fibrinolytic state. Scand. J. Haemat 1: 313 1965;
• 22 Nilsson I. M, Blombäck M, Ramgren O. Haemophilia in Sweden. I. Coagulation studies. Acta med. scand 170: 665 1961;
• 23 Nilsson I. M, Eiken O. Further studies on the effect of dextran of various molecular weight on the coagulation mechanism. Thrombos. Diathes. haemorrh. (Stuttg.) 11: 38 1964;
• 24 Nilsson I. M, Magnusson S, Borchgrevink C. The Duke and Ivy methods for determination of the bleeding time. Thrombos. Diathes. haemorrh. (Stuttg.) 10: 223 1963;
• 25 Nilsson I. M, Olow B. Fibrinolysis induced by streptokinase in man. Acta chir. scand 123: 247 1962;
• 26 Nilsson I. M, Olow B. Determination of fibrinogen and fibrinogenolytic activity. Thrombos. Diathes. haemorrh. (Stuttg.) 8: 297 1962;
• 27 Owren P.A. Coronary thrombosis. Its mechanism and possible prevention by linolenic acid. Ann. intern. Med 63: 167 1965;
• 28 Sawyer R. B, Moncrief J. A. Dextran specificity in thrombus inhibition. Arch. Surg 90: 562 1965;
• 29 Sawyer R. B, Moncrief J. A, Canizaro P.C. Dextran therapy in thrombophlebitis. JAMA 191: 740 1965;
• 30 Seegers W. H, Levine W. G, Johnson S. A. Inhibition of prothrombin activation with dextran. J. appl. Physiol 7: 617 1955;
• 31 Winfrey E. W, Foster J. H. Low molecular weight dextran in small artery surgery. Arch. Surg 88: 78 1964;
• 32 Fischer M, Wimmer H. Aktivierung des fibrinolytischen Systems durch niedermolekulares Dextran. Xth Congr. Internat. Soc. Blood Transf. P 13: 14 1964;