Tranexamic acid: From trauma to routine perioperative use

Jeff Simmons, Robert A. Sikorski, Jean Francois Pittet

Research output: Contribution to journalReview article


Purpose of review: Optimizing hemostasis with antifibrinolytics is becoming a common surgical practice. Large clinical studies have demonstrated efficacy and safety of tranexamic acid (TXA) in the trauma population to reduce blood loss and transfusions. Its use in patients without pre-existing coagulopathies is debated, as thromboembolic events are a concern. In this review, perioperative administration of TXA is examined in nontrauma surgical populations. Additionally, risk of thromboembolism, dosing regimens, and timing of dosing are assessed. Recent findings: Perioperative use of TXA is associated with reduced blood loss and transfusions. Thromboembolic effects do not appear to be increased. However, optimal dosing and timing of TXA administration is still under investigation for nontrauma surgical populations. Summary: As part of a perioperative blood management programme, TXA can be used to help reduce blood loss and mitigate exposure to blood transfusion.

Original languageEnglish (US)
Pages (from-to)191-200
Number of pages10
JournalCurrent Opinion in Anaesthesiology
Issue number2
StatePublished - Apr 7 2015



  • fibrinolysis
  • perioperative
  • thromboembolism
  • tranexamic acid
  • transfusion

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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