Last reviewed 2026-04-22 · How we verify

After CPB Tranexamic Acid

Tranexamic acid inhibits fibrinolysis by blocking plasminogen activation, reducing blood loss during and after cardiopulmonary bypass surgery.

Tranexamic acid inhibits fibrinolysis by blocking plasminogen activation, reducing blood loss during and after cardiopulmonary bypass surgery. Used for Reduction of blood loss and transfusion requirements in patients undergoing cardiopulmonary bypass surgery.

At a glance

Mechanism of action

Tranexamic acid is an antifibrinolytic agent that competitively inhibits the conversion of plasminogen to plasmin, thereby preventing the breakdown of fibrin clots. During cardiopulmonary bypass, excessive fibrinolysis occurs due to surgical trauma and blood contact with bypass circuits. By reducing fibrinolysis, tranexamic acid decreases postoperative bleeding and the need for blood transfusions in cardiac surgery patients.

Approved indications

• Reduction of blood loss and transfusion requirements in patients undergoing cardiopulmonary bypass surgery

Common side effects

• Thromboembolic events (deep vein thrombosis, pulmonary embolism)
• Seizures
• Renal dysfunction
• Visual disturbances

Key clinical trials

• COmbined pLaTelet and eRythrocyte AutotransfusioN During Cardiac surgEry (COLTRANE) Trial (NA)
• Point-of-care Measurement of the Antifibrinolytic Activity of Tranexamic Acid in Cardiac Surgery (PHASE4)
• Use of PRP in Open Surgery for Type A Aortic Dissection (PHASE2, PHASE3)
• Decreasing Postoperative Blood Loss and Seizures by Timing of Intravenous Tranexamic Acid 2 Pilot Trial (PHASE3)
• Tranexamic Acid Dose and Confusion After Cardiac Surgery
• The Role of Tranexamic Acid in Reducing Blood Transfusion Requirements After Cardiopulmonary Bypass in Neonates

Primary sources

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