Grant: Project Grant

Liver resection is the optimal treatment for patients with liver tumors. Despite improvements in preoperative imaging and evaluation of liver functional reserve, intraoperative blood loss remains a major risk factor for postoperative complications and long-term survival. Furthermore, packed red blood cells are limited in supply and there are a number of risks specific to receiving blood transfusion. Several strategies to reduce blood loss during liver resection have been developed and tested including operative and non-operative interventions. Despite these improvements, bleeding remains a problem during major liver resection with up to 30% of patients receiving blood products. Thus, further interventions to reduce bleeding and blood transfusion during liver surgery are sorely needed. Tranexamic Acid (TXA) is a drug that decreases bleeding and blood transfusion in a number of settings, including multisystem trauma, orthopaedic surgery, and cardiac surgery. In Canada, TXA is rarely used in patients undergoing liver surgery. This grant will support a multicentre, blinded, definitive RCT examining the impact of TXA on blood transfusion and long-term survival in patients undergoing liver resection.