The many roles of tranexamic acid: An overview of the clinical indications for TXA in medical and surgical patients

Johnny Cai, Jessica Ribkoff, Sven Olson, Vikram Raghunathan, Hanny Al-Samkari, Thomas G. DeLoughery, Joseph J. Shatzel

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

Clinically significant bleeding can occur as a consequence of surgery, trauma, obstetric complications, anticoagulation, and a wide variety of disorders of hemostasis. As the causes of bleeding are diverse and not always immediately apparent, the availability of a safe, effective, and non-specific hemostatic agent is vital in a wide range of clinical settings, with antifibrinolytic agents often utilized for this purpose. Tranexamic acid (TXA) is one of the most commonly used and widely researched antifibrinolytic agents; its role in postpartum hemorrhage, menorrhagia, trauma-associated hemorrhage, and surgical bleeding has been well defined. However, the utility of TXA goes beyond these common indications, with accumulating data suggesting its ability to reduce bleeding and improve clinical outcomes in the face of many different hemostatic challenges, without a clear increase in thrombotic risk. Herein, we review the literature and provide practical suggestions for clinical use of TXA across a broad spectrum of bleeding disorders.

Original languageEnglish (US)
Pages (from-to)79-87
Number of pages9
JournalEuropean Journal of Haematology
Volume104
Issue number2
DOIs
StatePublished - Feb 1 2020

Keywords

  • antifibrinolytic agents
  • coagulants
  • fibrin modulating agents
  • heavy menstrual bleeding
  • hematologic agents
  • hematologic disorders
  • hemophilia
  • hemorrhage
  • hemostatic
  • postpartum hemorrhage
  • tranexamic acid
  • trauma

ASJC Scopus subject areas

  • Hematology

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