A Systematic Review of the Effects of Tranexamic Acid on Intraoperative Bleeding and Transfusion Requirements in Hepatic Resection Surgeries

Introduction: The use of tranexamic acid in hepatic resection holds significant clinical importance due to its potential to reduce intraoperative blood loss and minimize reliance on allogeneic transfusions, which are associated with increased morbidity, mortality, and oncologic risk. Given the liver’s complex vascular anatomy and fragile hemostatic balance, optimizing bleeding control while preserving safety is critical. A clearer understanding of TXA’s efficacy and risks can directly impact surgical outcomes and perioperative care standards.Material and methods: This systematic review, following PRISMA guidelines, evaluated the impact of tranexamic acid on intraoperative bleeding and transfusion needs in hepatic resection. Eligible studies included RCTs and observational research involving adult patients. Comprehensive database searches, independent data extraction, and validated risk of bias assessments were conducted. Meta-analyses were performed where appropriate, with heterogeneity explored through subgroup and sensitivity analyses, providing a robust evidence base on the perioperative efficacy of tranexamic acid in liver surgery. Results: This systematic review included six comparative studies evaluating tranexamic acid (TXA) in hepatic resection. TXA significantly reduced intraoperative blood loss and perioperative transfusion requirements compared to control or placebo. Both transfusion incidence and PRBC volumes were consistently lower in the TXA groups. These findings support the efficacy of intravenous TXA in minimizing bleeding and transfusion burden, indicating a beneficial role.Conclusion: Tranexamic acid administration during hepatic resection significantly reduces intraoperative blood loss and decreases the need for perioperative blood transfusions. Consistently lower transfusion volumes and reduced transfusion incidence were observed across diverse patient populations and dosing regimens.

کلیدواژه ها:

Tranexamic acid ، Hepatic Resection ، Intraoperative Bleeding ، Blood Transfusion Requirements