Efficacy of Tranexamic Acid to Reduce Blood Loss in Hepatectomy

Abstract

Introduction: Hepatectomy is a complex surgery with high risk of bleeding. Tranexamic acid (TXA) administration has been proved to reduce intraoperative bleeding in many major surgeries. However, the efficacy of TXA to reduce blood loss in hepatectomy is inconsistent. Objective: To evaluate the efficacy of TXA for the reduction of blood loss in hepatectomy at Khon Kaen Hospital. Methods: This was a retrospective cohort study using propensity score matching. The medical records of patients with aged 18 or above undergoing hepatectomy at Khon Kaen Hospital between March 2016 and September 2020 were reviewed. They were divided to TXA and Control groups. Propensity scores were calculated from the confounding factors regarding intraoperative bleeding. The patients with equal propensity score were matched and analyzed. Results: Before propensity score matching, 109 patients were recruited, 48 in TXA and 61 in Control group. Both groups had similar blood loss (1,108.1±1,229.3 mL and 834.2±805.3 mL, P-value = 0.189). After propensity score matching, 51 patients were recruited, 22 in TXA and 29 in Control group. Both groups had comparable blood loss (840.0±936.3 mL and 825.2±762.4 mL, P-value = 0.951). No significant differences in intraoperative fluid and blood component administration were found both before and after matching. Neither complication nor mortality was identified. Conclusions: TXA administration did not reduce intraoperative bleeding in patients undergoing hepatectomy. Intraoperative fluid and blood component administration were similar between groups. Neither complication nor mortality was identified.