Anaesthesia and Intensive Care· 2026Q2
The impact of tranexamic acid on graft function in liver transplantation: A randomised controlled trial
- 0citations
- Q2SCImago
- 2026year
Short summary
Tranexamic acid (TXA) did not improve early allograft function in liver transplant recipients, with a higher incidence of early dysfunction (28% vs 13%) and elevated post-operative day 1 AST levels (841 vs 622 IU/L) in the TXA group compared to placebo.
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Key points
- Early allograft dysfunction occurred in 28% of patients receiving TXA versus 13% in the placebo group (P=0.08).
- Median AST levels on post-operative day 1 were significantly higher in the TXA group (841 IU/L) compared to the control group (622 IU/L) (P=0.03).
- TXA did not significantly reduce transfusion volume, incidence of acute kidney injury, thromboembolic events, or improve survival.
- The study concludes TXA administration failed to demonstrate beneficial effects on early graft dysfunction or other perioperative outcomes.
AI-generated from the title and abstract; the full text is not read.
Abstract
Tranexamic acid (TXA) has been reported to reduce transfusion requirements in liver transplantation (LT). However, clinical evidence regarding the impact of TXA on graft function and other outcomes in liver transplant recipients remains limited. This study aimed to evaluate the effect of TXA on early allograft function following LT. In this prospective, single-centre, randomised study, 89 adult participants scheduled for LT were randomised to receive either TXA or placebo. After anaesthesia induction, a continuous infusion of TXA (10 mg/kg/h) was maintained until portal vein unclamping in the TXA group, while the control group received an equivalent volume of 0.9% saline. The anaesthesia protocol was standardised across both groups. Within 7 days post-transplantation, early allograft dysfunction occurred in 12 of 43 patients in the TXA group compared with 6 of 46 patients in the control group (28% vs 13%, P =0.08). Median aspartate transaminase level was significantly higher in the TXA group on post-operative day 1 compared to the control group (841 vs 622 IU/L, P =0.03). No significant differences were observed between the two groups in transfusion volume, acute kidney injury incidence, thromboembolic events, hospital length of stay, total hospitalisation costs, in-hospital mortality and 180-day survival. TXA administration in liver transplant patients failed to demonstrate beneficial effects on incidence of early graft dysfunction, transfusion requirements or other perioperative outcomes compared to placebo. The routine use of TXA must be undertaken with caution.
The authors' abstract, as published at the source. Anaesthesia and Intensive Care, 2026 · DOI ↗
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Field: Biochemistry (Medicine)
BiochemistryMedicine