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Background <p>Perioperative bleeding complications are common adverse events. Tranexamic acid (TXA), through inhibition of fibrinolysis, may contribute to a&#xa0;reduction of such events. However, safety concerns remain, particularly with respect to thromboembolic complications.</p> Objective <p>This study aimed to evaluate whether TXA constitutes a&#xa0;meaningful and safe measure for prevention of bleeding complications. Potential areas of application include perioperative care as well as emergency management.</p> Materials and methods <p>A&#xa0;literature search of the MEDLINE database via PubMed, Google Scholar, and the Cochrane Library was conducted for publications in German and English from 2015 to 2025. The systematic literature search was prospectively registered with PROSPERO (CRD420251162415) and followed the PRISMA guidelines. Reviews and comments were excluded. A&#xa0;total of 32&#xa0;full-text articles were considered for final analysis.</p> Results <p>Tranexamic acid has been investigated in transurethral resection of the prostate (TURP), prostatectomy, radical cystectomy, and percutaneous nephrolithotomy (PCNL). Both topical and systemic administration of TXA were associated with a&#xa0;reduction in bleeding complications. Several studies demonstrated a&#xa0;significantly reduced postoperative hemoglobin drop and decreased bleeding volume. In cases of greater blood loss, transfusion rates were also reliably reduced. Catheterization time and hospital stay were largely unchanged. The duration and dosage of TXA administration varied across studies. No increased incidence of thromboembolic events was observed. Since patients with cardiovascular risk factors were frequently excluded, no reliable data are available for this subgroup.</p> Conclusion <p>In otherwise healthy patient populations, TXA appears to be a&#xa0;safe and effective means of preventing bleeding complications. Further studies are warranted in patients with cardiovascular risk factors before its unrestricted use can be recommended.</p>

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Tranexamsäure zur Vermeidung von Blutungskomplikationen – eine sinnvolle Maßnahme?

  • 期刊论文

  • 发表日期：

    2025年12月9日

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  • Jakob Schalla,
  • Fabian P. Stangl,
  • Matthias Saar,
  • Jennifer Kranz,
  • Georgios Gakis

摘要

Background

Perioperative bleeding complications are common adverse events. Tranexamic acid (TXA), through inhibition of fibrinolysis, may contribute to a reduction of such events. However, safety concerns remain, particularly with respect to thromboembolic complications.

Objective

This study aimed to evaluate whether TXA constitutes a meaningful and safe measure for prevention of bleeding complications. Potential areas of application include perioperative care as well as emergency management.

Materials and methods

A literature search of the MEDLINE database via PubMed, Google Scholar, and the Cochrane Library was conducted for publications in German and English from 2015 to 2025. The systematic literature search was prospectively registered with PROSPERO (CRD420251162415) and followed the PRISMA guidelines. Reviews and comments were excluded. A total of 32 full-text articles were considered for final analysis.

Results

Tranexamic acid has been investigated in transurethral resection of the prostate (TURP), prostatectomy, radical cystectomy, and percutaneous nephrolithotomy (PCNL). Both topical and systemic administration of TXA were associated with a reduction in bleeding complications. Several studies demonstrated a significantly reduced postoperative hemoglobin drop and decreased bleeding volume. In cases of greater blood loss, transfusion rates were also reliably reduced. Catheterization time and hospital stay were largely unchanged. The duration and dosage of TXA administration varied across studies. No increased incidence of thromboembolic events was observed. Since patients with cardiovascular risk factors were frequently excluded, no reliable data are available for this subgroup.

Conclusion

In otherwise healthy patient populations, TXA appears to be a safe and effective means of preventing bleeding complications. Further studies are warranted in patients with cardiovascular risk factors before its unrestricted use can be recommended.