Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Dextran is a polysaccharide that has been used clinically as a plasma volume expander and as an antithrombotic agent, particularly for the prevention of blood clots. The scientific justification for its use lies in its mechanism of action: dextran reduces blood viscosity, inhibits platelet aggregation, and interferes with fibrin polymerization, all of which can help prevent the formation of thrombi (blood clots). Clinical studies, especially in the mid-to-late 20th century, demonstrated that dextran—especially low molecular weight dextran (Dextran 40)—could reduce the incidence of postoperative deep vein thrombosis and other thromboembolic events in surgical patients, particularly after orthopedic and vascular procedures. Its efficacy in this context led to its widespread adoption in perioperative settings before the advent of more modern anticoagulants and antiplatelet agents.

However, the use of dextran for this purpose has declined due to the availability of safer and more effective alternatives (e.g., low molecular weight heparins, direct oral anticoagulants) and concerns over potential adverse effects such as anaphylaxis, bleeding, and interference with blood cross-matching. Nonetheless, the evidence supporting dextran’s antithrombotic action is robust, with numerous controlled trials and meta-analyses from the latter half of the 20th century validating its efficacy in clot prevention. Its use today is more limited and situation-dependent, but the scientific foundation for its antithrombotic role is well established.

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