Major Contribution to Thrombosis Research

Our multidisciplinary programme of laboratory and clinical research has contributed to major advances in venous thromboembolism that have changed clinical practice.

Thrombosis research related to the early detection, prevention and treatment of post operative venous thromboembolism was started in 1965 with a staff of two. Work conducted by the Institute’s Founder, Emeritus Professor Vijay Kakkar describing the natural history of deep vein thrombosis in surgical patients was among the first to identify the magnitude of this now widely recognised problem (1969). By describing venous thromboembolism’s cause and effect, he demonstrated for the first time the extent of the problem and the impact for surgical patients of pulmonary embolism.

Having defined the problems of venous thromboembolism, Professor Vijay Kakkar then pioneered new methods for its detection, prevention and treatment. In the early 1970s, he established that deep vein thrombosis/ pulmonary embolism could be prevented in surgical patients by using a fixed low dose of heparin, an anticoagulant.

In 1975, a major mortality outcome study ‘The International Multicentre Trial’ (Kakkar VV, et al. Prevention of fatal postoperative pulmonary embolism by low doses of heparin. Lancet 1975;306:45-64) coordinated by the Thrombosis Research Institute validated Professor Kakkar’s original research into the prevention of peri and post-operative death from pulmonary embolism. This trial, considered the seminal work in the field, found that heparin prophylaxis reduces death from pulmonary embolism, saving seven lives for every 1,000 operated patients.

In 1982, the first clinical evaluation of low molecular weight heparin in the prevention of deep vein thrombosis was published by staff at the Institute. Since then, a continuous programme of basic and clinical research has further evaluated these agents for the prevention of both arterial and venous thromboembolism, helping to establish low molecular weight heparins as the gold standard for antithrombotic therapy over the past 20 years.

These methods are now used throughout the world and have resulted in the near eradication of deaths due to thrombosis in high risk patients undergoing major surgery, saving approximately 300,000 lives per year worldwide.