London School of Hygiene & Tropical Medicine

The authors, from the London School of Hygiene & Tropical Medicine, reviewed the results of 129 clinical trials of the administration of tranexamic acid to patients undergoing a wide range of planned surgical operations and found that the drug reduces the chances of receiving a blood transfusion by about a third. This would mean that more than 100,000 surgical patients could avoid receiving transfusions in the NHS every year.* 

There were also fewer surgical deaths in patients treated with tranexamic acid although the authors believe that larger trials are needed to be sure about this.

Tranexamic acid works by stabilising blood clots and reduces the amount of bleeding during surgery. It has been used for many years and is sold over the counter for women with heavy periods.

The study authors wrote: “Strong evidence that tranexamic acid reduces blood transfusion in surgery has been available for many years...Surgical patients should be made aware of this evidence so that they can make an informed choice.”

Professor Ian Roberts, one of the authors, added: “Blood transfusions can save lives but the procedure is not entirely without risk. Patients should be given more information and choice before they go ahead with a planned operation.”

Although in the UK donated blood is screened for many infections, in many low income countries donated blood is not adequately screened and many patients are at risk of contracting infections such as HIV through transfusions.  By reducing the number of patients who receive a transfusion, tranexamic could be an important tool for reducing the burden of HIV and other dangerous infections.

As well as reducing the hazards of blood transfusion, tranexamic acid makes economic sense, the study suggests. A dose of tranexamic acid costs £3 whereas a blood transfusion costs £125 per pint. The researchers estimate that tranexamic acid use could save the NHS up to £25 million each year even without taking into account the cost of treating transfusion associated health problems.

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