Danaparoid Sodium : A Review of Its Use in Hepatic Thrombotic Disorders

Danaparoid sodium is an antithrombotic isolated from porcine mucosa. Its main constituent is a mixture of heparan sulphates that inhibits thrombin generation and also possesses anti-inflammatory and immune-modulatory activity. It has shown safety and efficacy in its main indications of deep venous thrombosis prophylaxis, heparin-induced thrombocytopenia treatment and disseminated intravascular thrombosis treatment. In addition, there are reports of its off-label use for the treatment of portal vein thrombosis in adults and for prevention of the hepatic thrombotic microangiopathies haematogenous that complicate recovery after stem cell transplantation in adults and children. The results of these studies provide further support for its safety and efficacy even in subjects with cirrhosis and/or severe hepatic dysfunction. In this chapter the rationale for danaparoid use is presented and the collated results of comparative studies and case reports are compared with those of other pharmaceutical options for managing these hepatic thrombotic disorders.