Application of tranexamic acid on effects of intraoperative hemorrhage in liver transplantation / 中国输血杂志

ABSTRACT

Objective To evaluate the efficacy and safety of tranexamic acid in blood protection in liver transplantation.Methods We searched the Cochrane library,MEDLINE,CNKI,VIP,CBM (from inception to May 2017),to collect all the randomized controlled trials of tranexamic acid for liver transplantation.the quality of the included studies was evaluated,and meta-analyses were performed with Cochrane Collaboration's RevMan 5.3 software.Results 1) A total of 8 studies involving 1107 patients were included.the results of meta-analyses showedCompared with placebo,tranexamic acid was effective in reducing postoperative blood loss [SMD =-1.95,95％ CI (-3.21,-0.69)],P＜0.05],there were statistical heterogeneity between the studies (I2=94％,P＜0.05),2)Tranexamic acid was effective in reducing postoperative transfusion rates of RBC during the operation [SMD=-0.43,95％ CI (-0.74,-0.11)],P＜0.05];however,less effective than the placebo in terms of reducing postoperative FFP and PLT transfusion.Compared with placebo and other antifibrinolitic drugs the bleeding,renal insufficiency,thrombosis,infection,death and the incidence of other adverse events were not increased in tranexamic acid group after surgery.Conclusion Tranexamic acid was a safe and effective antifibrinolitic drug in liver transplantation,for it can reduce the amount of bleeding and red blood cell transfusion,However,due to the limited quality of the included studies,further verification with more high quality trials was needed.