Tranexamic acid - a promising hemostatic agent with limitations: a narrative review

• Published in: Korean journal of anesthesiology 2024, 77(4), , pp.411-422
• Main Authors: Kim, Dong Joon, Cho, Su Yeon, Jung, Ki Tae
• Format: Article
• Language: English
• Subjects: Antifibrinolytic Agents - administration & dosage; Antifibrinolytic Agents - therapeutic use; Blood Loss, Surgical - prevention & control; blood transfusion; cardiac surgical procedures; hemorrhage; Hemostatics - administration & dosage; Hemostatics - therapeutic use; Humans; neurosurgery; orthopedic procedures; postpartum hemorrhage; Review; tranexamic acid; Tranexamic Acid - administration & dosage; Tranexamic Acid - therapeutic use; trauma; 마취과학
• ISSN: 2005-6419; 2005-7563; 2005-7563
• DOI: 10.4097/kja.23530

Tranexamic acid (TXA) is a synthetic antifibrinolytic agent that has been used for several decades to reduce blood loss during surgery and after trauma. TXA was traditionally used to reduce bleeding in various clinical settings such as menorrhagia, hemophilia, or other bleeding disorder. Numerous studies have demonstrated the efficacy of TXA in reducing blood loss and the need for transfusions. Interest in the potential applications of TXA beyond its traditional use has been growing recently, with studies investigating the use of TXA in postpartum hemorrhage, cardiac surgery, trauma, neurosurgery, and orthopedic surgery. Despite its widespread use and expanding indications, data regarding the safe and appropriate use of TXA is lacking. Recent clinical trials have found various potential risks and limitations in the long-term benefits of TXA. This narrative review summarizes the clinical applications and limitations of TXA.