The Effectiveness and Safety of Tranexamic Acid in Orthotopic Liver Transplantation Clinical Practice

Badenoch, Adam; Sharma, Anand; Gower, Simon; Selzner, Markus; Srinivas, Coimbatore; Wąsowicz, Marcin; McCluskey, Stuart A.

doi:10.1097/tp.0000000000001682

Cited by 42 publications

(28 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For this reason, tranexamic acid is often used, either in a prophylactic manner or according to viscoelastic tests. Notably, many studies do not detect thrombotic complications and therefore suggest that tranexamic acid is a safe medication in this setting [ 8 , 15 ]. Two recent studies, however, interpreted their findings on TEG™ clot lysis with mortality as a harmful effect of hypofibrinolysis and fibrinolytic shutdown [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Pre-Liver Transplant ROTEM™ Clot Lysis Index Is Associated with 30-Day Mortality, But Is Not a Measure for Fibrinolysis

Hartmann

Craciun

Paul

et al. 2020

JCM

View full text Add to dashboard Cite

Complex alterations of the coagulation system in end stage liver disease lead to an increased risk of bleeding and mortality. In the present study, we investigated; 1. the association of pre-liver transplant rotational thrombelastometry (ROTEM™) variables with bleeding as well as 30-day-mortality and 2. the underlying pathophysiology. After approval from the local ethics committee, rotational thrombelastometry variables, conventional laboratory coagulation values, MELD score (model of end-stage liver disease), red blood cell loss, blood product use, coagulation factors, underlying disease, and demographic data were retrospectively analysed. Pre-transplant thrombelastometry clot lysis index (CLI) and MELD were the only variables associated with mortality, bleeding and blood product use, respectively. Mortality was 4.2%, when CLI was <85%, and increased to 25.7% when the CLI was >95%. Multivariate analysis including CLI and MELD score identified the CLI as an independent and the best predictor of 30-day-mortality. Interestingly, the inhibition of fibrinolysis did neither affect CLI nor the association of the variable with mortality. Thus, fibrinolysis can be excluded as the reason for low CLI values. In conclusion, low CLI values measured before the beginning of liver transplantation are associated with reduced bleeding and mortality, but do not indicate fibrinolysis.

show abstract

Section: Discussionmentioning

confidence: 99%

Pre-Liver Transplant ROTEM™ Clot Lysis Index Is Associated with 30-Day Mortality, But Is Not a Measure for Fibrinolysis

Hartmann

Craciun

Paul

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…42 In a randomized trial, Badenoch et al demonstrated that the efficacy of TXA in reducing blood loss and transfusion requirements during liver transplantation without increasing the risk of thromboembolic events. 43 In literature, RCTs demonstrated approximately (30-40)% reduction in bleeding and need for transfusion requirements during orthotopic liver transplantation as compared to placebo group. 43…”

Section: Efficacy Of Txa In Liver Surgerymentioning

confidence: 99%

“…43 In literature, RCTs demonstrated approximately (30-40)% reduction in bleeding and need for transfusion requirements during orthotopic liver transplantation as compared to placebo group. 43…”

Section: Efficacy Of Txa In Liver Surgerymentioning

confidence: 99%

Role of tranexamic acid to reduce blood loss and transfusion of allogeneic blood in the field of surgery

Shrestha

Tao

2020

Asian J Med Sci

View full text Add to dashboard Cite

Tranexamic acid is widely used as an antifibrinolytic drug to reduce blood loss intraoperative and postoperative time periods as well as to reduce transfusion of allogeneic blood. After releasing in the market, multidisciplinary surgeries have wide use of tranexamic acid due to its antifibrinolytic effect to reduce bleeding and transfusion of blood. In literature, there were mentioned a few adverse effects like thromboembolism, seizure, anaphylactic reaction, etc which are still unsolved questions to date. The aim of this review to minimize the blood loss from acute bleeding in different situations by updating the doses used in a different clinical scenario,since the release of tranexamic acid. It also gives an idea about appropriate doses to reduce blood loss, need for blood transfusion, minimize adverse effects and to understand the wide scope of application of TXA to date.

show abstract

“…64 Three recent studies demonstrated that prophylactic use of lysine analogs decreased transfusion requirements, although one study showed that antifibrinolytic therapy was associated with a higher risk of deep venous thromboses. [97][98][99] Postoperative Care of the Liver Transplant Recipient…”

Section: Neohepatic Stagementioning

confidence: 99%

Perioperative Considerations in Liver Transplantation

Lopez

Steadman

Wray

et al. 2018

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Liver transplantation (LT) has the potential to cure patients with acute and chronic liver failure as well as a number of hepatic and biliary malignancies. Over time, due to the increasing demand for organs as well as improvements in the survival of LT recipients, patients awaiting LT have become sicker, and often undergo the procedure while critically ill. This trend has made the process of preoperative assessment and planning, intraoperative management, and postoperative management even more crucial to the success of LT programs. Multidisciplinary and specialized teams are essential and include anesthesiologists, surgeons, and intensivists. This article focuses on the preoperative evaluation, intraoperative care, and postoperative management of the liver transplant patient. Management relevant to the critically ill patient is discussed, with a focus on the management of postoperative cardiopulmonary conditions including the care of special populations such as those with hepatopulmonary syndrome and portopulmonary hypertension.

show abstract

The Effectiveness and Safety of Tranexamic Acid in Orthotopic Liver Transplantation Clinical Practice

Cited by 42 publications

References 19 publications

Pre-Liver Transplant ROTEM™ Clot Lysis Index Is Associated with 30-Day Mortality, But Is Not a Measure for Fibrinolysis

Pre-Liver Transplant ROTEM™ Clot Lysis Index Is Associated with 30-Day Mortality, But Is Not a Measure for Fibrinolysis

Role of tranexamic acid to reduce blood loss and transfusion of allogeneic blood in the field of surgery

Perioperative Considerations in Liver Transplantation

Contact Info

Product

Resources

About