Tranexamic acid for reduction of perioperative blood loss in major abdominal surgery

Abstract

The antifibrinolytic tranexamic acid (TXA) has been known to reduce hemorrhage in many different surgical fields. Aim of this Review was to assess the effectiveness and safety of TXA for reducing blood loss and transfusion requirements in major abdominal surgery. Nineteen trials involving a total of 3.087 patients were included. The results showed a significant reduction in number of patients requiring RBC transfusions (MD 0.67; 95% CI 0.48 to 0.92), required units of RBC (MD -1.73; 95% CI -3.05 to -0.41) and FFP (MD -1.90; 95% CI -3.58 to -0.22) under TXA. No significant differences regarding any other primary or secondary outcomes were found. The analyses support the use of TXA in major abdominal surgery to reduce transfusion requirements without indications of increased thromboembolic or other serious adverse events. Given the moderate quality of evidence further confirmation is needed.