Thrombosis desmopressin

There have been several reports of arterial thrombosis associated with the use of desmopressin, including myocardial infarction (23-27). One of these reports concerned a case of fatal myocardial infarction in a blood donor in excellent health, with no risk factors and no signs of vascular disease (25). 

Three other cases of myocardial infarction in the absence of desmopressin have been reported in patients with hemolytic-uremic syndrome, who already have an increased risk of thrombosis. 

There are isolated reports of thromboembolic complications in recipients of desmopressin most occurred in patients with pre-existing vascular disease. However, in nine trials of the hemostatic efficacy of desmopressin in reducing blood and transfusion requirements in 763 patients, there were no significant differences between the frequencies of thromboembolism in subjects treated with desmopressin and controls (33). An analysis of 31 clinical trials of desmopressin in patients undergoing cardiac, vascular, orthopedic, or other major surgery showed that desmopressin did not increase the incidence of thrombosis (34). 

A scientific registry of transplant recipients has been used to determine the effect of cadaveric organ donor treatment with desmopressin on the incidence of pancreas graft thrombosis in clinical pancreas transplantation (70). Of 2804 cases with sufficient information between 5 April 1994 and 27 September 2002, 1287 (46%) had received desmopressin. The mean follow up was 1.5 years (1 month to 8.4 years). There was pancreatic graft thrombosis in 4.3%, of whom 5.1% had received desmopressin and 3.5% had not this was just statistically significant. There was no information about dose, time-course, or duration of desmopressin use. It is not known whether this finding is clinically significant. 

Mannucci PM, Carlsson S, Harris AS. Desmopressin, surgery and thrombosis. Thromb Haemost 1994 71(l) 154-5. 

Marques RG, Rogers J, Chavin KD, Baliga PK, Lin A, Emovon O, Afzal F, Baillie GM, Taber DJ, Ashcraft EE, Rajagopalan PR. Does treatment of cadaveric organ donors with desmopressin increase the likelihood of pancreas graft thrombosis Results of a preliminary study. Transplant Proc 2004 36 1048-9. 

Very few adverse eEects are associated with desmopressin. The most commonly observed side effect is facial flushing. Less frequently reported side eEects include nuld headaches, increased heart rate, and decreased blood pressure. Thrombosis is a rare complication associated with desmopressin. Because of its antidiuretic eEects, desmopressin also has the potential to cause water... 

Hematologic Another report of the increased risk of thrombosis when desmopressin is used in von Willebrand s disease has highhghted the need for caution [48 ]. 

Venous thrombosis A case study reported the occurrence of venous thrombosis witiiin 1 h after intravenous application of desmopressin to a 76-year-old women with idiopathic diabetes insipidus 5 days after free flap transfer, highlighf-ing the potential risk of thrombotic incidents when desmopressin is used following microsurgical procedures [88 ]. 

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