Antifibrinolytics in orthotopic liver transplantation: Current status and controversies

Victor W. Xia, Randolph H. Steadman

Research output: Contribution to journalReview articlepeer-review

63 Scopus citations


This article reviews the current status and controversies of the 3 commonly used antifibrinolytics - epsilon-aminocaproic acid, tranexamic acid and aprotinin - during liver transplantation. There is no general consensus on how, when or which antifibrinolytics should be used in liver transplantation. Although these drugs appear to reduce blood loss and decrease transfusion requirements during liver transplantation, their use is not supported uniformly in clinical trials. Aprotinin has been studied more extensively in clinical trials and appear to offer more advantages compared to two other antifibrinolytics. Because of the diverse population of liver transplant recipients and the potential adverse effects of antifibrinolytics, especially life-threatening thromboembolism, careful patient selection and close monitoring is prudent. Further studies addressing the risks and benefits of antifibrinolytics in the setting of liver transplantation are warranted.

Original languageEnglish (US)
Pages (from-to)10-18
Number of pages9
JournalLiver Transplantation
Issue number1
StatePublished - Jan 2005

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation


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