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Related Experiment Video

Updated: Jun 5, 2026

Laparoscopic Anatomic S7+S8d Resection Preserving Inferior Right Hepatic Vein and S6 with Right Hepatic Vein Transection
06:00

Laparoscopic Anatomic S7+S8d Resection Preserving Inferior Right Hepatic Vein and S6 with Right Hepatic Vein Transection

Published on: December 30, 2025

Antifibrinolytics in liver surgery.

Jalpa Makwana1, Saloni Paranjape, Jyotsna Goswami

  • 1Department of Anaesthesia, Jaslok Hospital and Research Centre, Mumbai, India.

Indian Journal of Anaesthesia
|January 13, 2011
PubMed
Summary
This summary is machine-generated.

Antifibrinolytic drugs like tranexamic acid help reduce blood loss in liver surgery but carry risks. Tranexamic acid and aprotinin show comparable hemostatic effects, requiring careful patient selection.

Keywords:
Antifibrinolytic drugsblood transfusionhyperfibrinolysisorthotopic liver transplantation

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Area of Science:

  • Anesthesiology
  • Hepatology
  • Pharmacology

Background:

  • Hyperfibrinolysis is a significant complication causing blood loss during liver surgery and transplantation.
  • Antifibrinolytic drugs, including lysine analogues (epsilon aminocaproic acid, tranexamic acid) and aprotinin, are used to manage this complication.
  • Current guidelines on the optimal use of these drugs, including type, indication, and dosage, remain insufficient.

Purpose of the Study:

  • To systematically review clinical trials on antifibrinolytic drugs used in liver surgery and transplantation.
  • To compare the efficacy and safety of epsilon aminocaproic acid, tranexamic acid, and aprotinin.
  • To address the benefits and potential complications associated with antifibrinolytic therapy.

Main Methods:

  • Systematic literature search of PubMed and Cochrane Library.
  • Inclusion of studies comparing antifibrinolytic drugs (EACA, TA, aprotinin) against each other or placebo.
  • Analysis of intraoperative transfusion requirements, and perioperative incidence of hepatic artery thrombosis, venous thromboembolism, and mortality.

Main Results:

  • Epsilon aminocaproic acid (EACA) is the least studied among the three drugs.
  • Aprotinin use has been restricted due to side effects, despite its extensive study.
  • Aprotinin and tranexamic acid (TA) demonstrated comparable hemostatic effects.

Conclusions:

  • Antifibrinolytic drugs offer benefits like reduced transfusion needs but pose risks such as thromboembolism.
  • Individualized treatment and careful patient selection are crucial for effective antifibrinolytic therapy.
  • Further research is needed to establish clear guidelines for antifibrinolytic drug use in liver surgery and transplantation.