What is the role of tranexamic acid in minimizing blood loss during liver transplantation?

Updated: Apr 19, 2019
  • Author: Vanessa A Olcese, MD, PhD; Chief Editor: Ron Shapiro, MD  more...
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Tranexamic acid is another synthetic drug that inhibits fibrinolysis. [52] Both high- and low-dose tranexamic acid has significantly reduced the use of intraoperative PRBCs in several studies. [28, 29] Tranexamic acid also decreases postoperative transfusion requirements in some but not all studies.

In a double-blinded, randomized, controlled study, high-dose (20 g) tranexamic acid significantly reduced intraoperative blood loss and transfusion requirements for 45 consecutive liver transplantation subjects. Smaller doses were shown to reduce fibrinolysis without affecting transfusion requirements. Mechanisms of action are hypothesized to include decreased platelet aggregation inhibition and inhibition of plasmin-induced platelet dysfunction.

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