Tranexamic Acid Reduces Red Cell Transfusion Better than ε-Aminocaproic Acid or Placebo in Liver Transplantation

Abstract

In a randomized study of 132 consecutive patients undergoing liver transplantation, we found that tranexamic acid, but not epsilon-aminocaproic acid, reduced intraoperative total packed red blood cell transfusion.

Minimizing Blood Loss in Liver Transplantation: Progress through Research and Evolution of Techniques

“…The use of EACA in liver transplant patients has been studied in only one randomized, controlled study [63]. In this study, where patients were randomized to receive EACA, tranexamic acid or placebo, no differences in blood transfusion requirement were found between the EACA and placebo group.…”

“…In the first multicenter trial, reported by Planinsic et al [66], 82 patients were randomized to receive placebo, 20, 40, or 80 µg/kg rFVIIa as a single-dose at the start of the procedure. Although the use of a single dose regimen was in line with our initial pilot study [63], the positive effect on perioperative RBC transfusion requirements observed in the pilot study could not be reproduced in the multicenter trial. As regards safety, there were no significant differences in thromboembolic complications among the four groups in the multicenter study.…”

Thromboelastometric Profile in Patients with Prothrombotic Risk Factors Undergoing Liver Transplantation

“…We studied adult patients (≥ 18 years old) who received an orthotopic liver transplantation from October 2014 to June 2017 and had a presumedly prothrombotic coagulations status according to some authors [13,[20][21][22][23][24][25][26][27], such as: Budd-Chiari syndrome, protein C deficiency, malignant disease, multiple organ transplants, chronic renal failure, retransplantation for portal vein and hepatic artery thrombosis, portal vein and hepatic artery thrombosis, primary biliary cirrhosis.…”

“…This population presumably include patients with Budd-Chiari syndrome, protein C deficiency, malignant disease, multiple organ transplants and chronic renal failure, as well as retransplantation for portal vein or hepatic artery thrombosis, pre-existing thrombotic diseases and non-alcoholic steatohepatitis (NASH) [13,[20][21][22][23][24][25][26][27].…”

“…A such, baseline coagulation status and additional intraoperative disorders (e.g. hemodilution, consumption of factors and hyperfibrinolysis) contribute to intraoperative blood loss [13][14][15][16][17][18].…”