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Tranexamic Acid in Patients Undergoing Liver Resection: The HeLiX Randomized Clinical Trial.
Paul J Karanicolas1,2,3, Yulia Lin4,5, Stuart A McCluskey6,7
1Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
JAMA
|August 19, 2024
Summary
Tranexamic acid did not reduce red blood cell transfusions in liver resection patients for cancer. The study found no benefit in reducing bleeding but noted an increase in perioperative complications with its use.
Area of Science:
- Hepatopancreaticobiliary Surgery
- Oncology
- Pharmacology
Background:
- Tranexamic acid is used to reduce bleeding in various surgeries.
- Its efficacy in liver resections for cancer is not well-established.
Purpose of the Study:
- To evaluate the effectiveness of tranexamic acid in reducing red blood cell transfusions within 7 days of liver resection for cancer.
- To assess the impact of tranexamic acid on perioperative bleeding and complications.
Main Methods:
- A multicenter, randomized, double-blind, placebo-controlled trial involving 1245 patients undergoing liver resection for cancer.
- Patients received either tranexamic acid or a placebo.
- The primary outcome was red blood cell transfusion within 7 days.
Main Results:
- No significant difference in red blood cell transfusion rates between tranexamic acid and placebo groups (16.3% vs 14.5%).
- Similar intraoperative and total estimated blood loss in both groups.
- Tranexamic acid was associated with a significant increase in perioperative complications (OR, 1.28; P=.03).
Conclusions:
- Tranexamic acid does not reduce bleeding or the need for blood transfusions in patients undergoing liver resection for cancer.
- Its use in this patient population may increase the risk of perioperative complications.
