Anticoagulation Therapy Using with Danaparoid Sodium for Portal Venous Thrombosis

Abstract

Purpose: It is reported that portal venous thrombosis is caused concomitantly with a variety of diseases. However, the adequate treatment for portal venous thrombosis has yet to be established. In this study, we examined the effect of anticoagulation therapy using with danaparoid sodium for portal venous thrombosis. Methods: Portal venous thrombosis has been confirmed in 22 out of 641 cases of liver cirrhosis in our hospital since 1995. Danaparoid sodium is a low molecular weight heparinoid whose major component is heparan sulfate. Danaparoid sodium enhances the effect of antithrombin that inhibits coagulation factor. Compared to heparin and low molecular weight heparin, danaparoid sodium has a higher selective anti-Xa factor activity with lower risks of hemorrhage. Danaparoid sodium was administered to seven patients with portal venous thrombosis who were considered to have developed new thrombosis. One ampule (1250 anti Xa factor units) of danaparoid sodium was slowly injected intravenously every 12 hours (twice a day). After administration of danaparoid sodium, follow-ups by abdominal ultrasonography and CT were performed every two weeks. We studied the effects of danaparoid sodium by examining clinical findings, laboratory data, and imaging findings. Results: In all seven patients who were administered danaparoid sodium, patients were safely treated without any adverse effects and complications. Thrombosis in five out of seven patients disappeared within four weeks. However, recurrence of thrombosis was found after discontinuation of administration of danaparoid sodium in three out of five cases. In order to prevent recurrence, maintenance therapy by warfarin and aspirin was implemented after discontinuation of danaparoid sodium for some patients. However, it was not effective. When danaparoid sodium was re-administered to the recurrence cases, thrombosis disappeared within four weeks in all three recurrent cases. No adverse effect was found when danaparoid sodium was re-administered. Conclusion: It was suggested that danaparoid sodium might become an effective drug for treatment of portal venous thrombosis, since it was effective easily administered, and unlikely to cause adverse effects such as hemorrhage. We intend to examine indications, administration method, and establishment of maintenance therapy by investigating more cases.