Priority 7 from the Blood Transfusion and Blood Donation PSP

UNCERTAINTY: What are the best drug alternatives to blood transfusion to reduce and prevent bleeding? (JLA PSP Priority 7)
Overall ranking 7
JLA question ID 0063/7
Explanatory note Not available for this PSP
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6. Takagi H, Ando T, Umemoto T. Seizures associated with tranexamic acid for cardiac surgery: a meta-analysis of randomized and non-randomized studies. The Journal of Cardiovascular Surgery. 2017 Aug;58(4):633-641
7. Mi B, Liu G, Zhou W, Lv H, Liu Y, Zha K, et al. Intra-articular versus intravenous tranexamic acid application in total knee arthroplasty: a meta-analysis of randomized controlled trials. Archives of Orthopaedic and Trauma Surgery. 2017 Jul;137(7):997-1009.
8. Mi B, Liu G, Lv H, Liu Y, Zha K, Wu Q, et al. Is combined use of intravenous and intraarticular tranexamic acid superior to intravenous or intraarticular tranexamic acid alone in total knee arthroplasty? A meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2017 Apr 18;12(1):61. doi: 10.1186/s13018-017-0559-2.
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11. Li JF, Li H, Zhao H, Wang J, Liu S, Song Y, et al. Combined use of intravenous and topical versus intravenous tranexamic acid in primary total knee and hip arthroplasty: a meta-analysis of randomised controlled trials. Journal of Orthopaedic Surgery and Research. 2017;12(-1):22.
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16. Zhang P, Liang Y, Chen P, Fang Y, He J, Wang J. Intravenous versus topical tranexamic acid in primary total hip replacement: a meta-analysis. Medicine. 2016;95(-50):e5573-e.
17. Yuan ZF, Yin H, Ma WP, Xing DL. The combined effect of administration of intravenous and topical tranexamic acid on blood loss and transfusion rate in total knee arthroplasty: Combined tranexamic acid for TKA. Bone & Joint Research. 2016;5(-8):353-61.
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19. Winter SF, Santaguida C, Wong J, Fehlings MG. Systemic and topical use of tranexamic acid in spinal surgery: a systematic review. Global Spine Journal. 2016;6(-3):284-95.
20. Weng K, Zhang X, Bi Q, Zhao C. The effectiveness and safety of tranexamic acid in bilateral total knee arthroplasty: A meta-analysis. Medicine. 2016;95(-39):e4960-e.
21. Wang S, Gao X, An Y. Topical versus intravenous tranexamic acid in total knee arthroplasty: a meta-analysis of randomized controlled trials. International Orthopaedics. 2016.
22. Sun X, Dong Q, Zhang YG. Intravenous versus topical tranexamic acid in primary total hip replacement: a systemic review and meta-analysis. International Journal of Surgery (London, England). 2016.
23. Simonazzi G, Bisulli M, Saccone G, Moro E, Marshall A, Berghella V. Tranexamic acid for preventing postpartum blood loss after cesarean delivery: a systematic review and meta-analysis of randomized controlled trials. Acta Obstetricia et Gynecologica Scandinavica. 2016;95(-1):28-37.
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28. Olsen JJ, Skov J, Ingerslev J, Thorn JJ, Pinholt EM. Prevention of bleeding in orthognathic surgery - a systematic review and meta-analysis of randomized controlled trials. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2016;74(-1):139-50.
29. Murphy GR, Glass GE, Jain A. The efficacy and safety of tranexamic acid in cranio-maxillofacial and plastic surgery. The Journal of Craniofacial Surgery. 2016;27(-2):374-9.
30. McNicol ED, Tzortzopoulou A, Schumann R, Carr DB, Kalra A. Antifibrinolytic agents for reducing blood loss in scoliosis surgery in children. The Cochrane Database of Systematic Reviews. 2016(-9):CD006883-CD.
31. Lin Z, Xiaoyi Z. Tranexamic acid-associated seizures: a meta-analysis. Seizure. 2016;36:70-3.
32. Lin C, Qi Y, Jie L, Li HB, Zhao XC, Qin L, et al. Is combined topical with intravenous tranexamic acid superior than topical, intravenous tranexamic acid alone and control groups for blood loss controlling after total knee arthroplasty: a meta-analysis. Medicine. 2016;95(-51):e5344-e.
33. Li J, Zhang Z, Chen J. Comparison of efficacy and safety of topical versus intravenous tranexamic acid in total hip arthroplasty: a meta-analysis. Medicine. 2016;95(-36):e4689-e.
34. Li G, Sun TW, Luo G, Zhang C. Efficacy of antifibrinolytic agents on surgical bleeding and transfusion requirements in spine surgery: a meta-analysis. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2016.
35. Kietpeerakool C, Supoken A, Laopaiboon M, Lumbiganon P. Effectiveness of tranexamic acid in reducing blood loss during cytoreductive surgery for advanced ovarian cancer. The Cochrane Database of Systematic Reviews. 2016(-1):CD011732-CD.
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37. Kamhieh Y, Fox H. Tranexamic acid in epistaxis: a systematic review. Clinical Otolaryngology : Official Journal of Ent-Uk ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery. 2016.
38. Jiang X, Ma XL, Ma JX. Efficiency and safety of intravenous tranexamic acid in simultaneous bilateral total knee arthroplasty: a systematic review and meta-analysis. Orthopaedic Surgery. 2016;8(-3):285-93.
39. Jiang M, Chen P, Gao Q. Systematic review and network meta-analysis of upper gastrointestinal hemorrhage interventions. Cellular Physiology and Biochemistry : International Journal of Experimental Cellular Physiology, Biochemistry, and Pharmacology. 2016;39(-6):2477-91.
40. Javan R, Yousefi M, Nazari SM, Amiri P, Mosavi-Jarrahi A, Modiramani P, et al. Herbal medicines in idiopathic heavy menstrual bleeding: a systematic review. Phytotherapy Research : Ptr. 2016.
41. Hanna SA, Prasad A, Lee J, Achan P. Topical versus intravenous administration of tranexamic acid in primary total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials. Orthopedic Reviews. 2016;8(-3):6792-.
42. Gao F, Ma J, Sun W, Guo W, Li Z, Wang W. Topical fibrin sealant versus intravenous tranexamic acid for reducing blood loss following total knee arthroplasty: a systematic review and meta-analysis. International Journal of Surgery (London, England). 2016.
43. Fu Y, Shi Z, Han B, Ye Y, You T, Jing J, et al. Comparing efficacy and safety of 2 methods of tranexamic acid administration in reducing blood loss following total knee arthroplasty: a meta-analysis. Medicine. 2016;95(-50):e5583-e.
44. Farrow LS, Smith TO, Ashcroft GP, Myint PK. A systematic review of tranexamic acid in hip fracture surgery. British Journal of Clinical Pharmacology. 2016.
45. Estcourt LJ, Desborough M, Brunskill SJ, Doree C, Hopewell S, Murphy MF, et al. Antifibrinolytics (lysine analogues) for the prevention of bleeding in people with haematological disorders. The Cochrane Database of Systematic Reviews. 2016(-3):CD009733-CD.
46. Desborough M, Hadjinicolaou AV, Chaimani A, Trivella M, Vyas P, Doree C, et al. Alternative agents to prophylactic platelet transfusion for preventing bleeding in people with thrombocytopenia due to chronic bone marrow failure: a meta-analysis and systematic review. The Cochrane Database of Systematic Reviews. 2016(-10):CD012055-CD.
47. de Vasconcellos SJ, de Santana Santos T, Reinheimer DM, Faria ESAL, de Melo MF, Martins-Filho PR. Topical application of tranexamic acid in anticoagulated patients undergoing minor oral surgery: a systematic review and meta-analysis of randomized clinical trials. Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery. 2016.
48. Chen Y, Chen Z, Cui S, Li Z, Yuan Z. Topical versus systemic tranexamic acid after total knee and hip arthroplasty: a meta-analysis of randomized controlled trials. Medicine. 2016;95(-41):e4656-e.
49. Chen X, Zhu X, Yang S, Lin W, Wang L. Tranexamic acid treatment decreases hidden blood loss in total knee arthroplasty. American Journal of Therapeutics. 2016;23(-6):e1397-e405.
50. Chen S, Wu K, Kong G, Feng W, Deng Z, Wang H. The efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis. Bmc Musculoskeletal Disorders. 2016;17(-1):81-.
51. Yue, Pei F, Yang P, Xie J, Kang P. Effect of topical tranexamic acid in reducing bleeding and transfusions in TKA. Orthopedics. 2015;38(-5):315-24.
52. Yu X, Li W, Xu P, Liu J, Qiu Y, Zhu Y. Safety and efficacy of tranexamic acid in total knee arthroplasty. Medical Science Monitor. 2015;21:3095-103.
53. Xu X, Xiong S, Wang Z, Li X, Liu W. Topical administration of tranexamic acid in total hip arthroplasty: a meta-analysis of randomized controlled trials. Drug Discoveries & Therapeutics. 2015;9(-3):173-7.
54. Wu Q, Zhang HA, Liu SL, Meng T, Zhou X, Wang P. Is tranexamic acid clinically effective and safe to prevent blood loss in total knee arthroplasty? A meta-analysis of 34 randomized controlled trials. European Journal of Orthopaedic Surgery & Traumatologie. 2015;25(3):525-41.
55. White N, Bayliss S, Moore D. Systematic review of interventions for minimizing perioperative blood transfusion for surgery for craniosynostosis. Journal of Craniofacial Surgery. 2015;26(1):26-36.
56. Wei Z, Liu M. The effectiveness and safety of tranexamic acid in total hip or knee arthroplasty: a meta-analysis of 2720 cases. Transfusion Medicine. 2015;25(-3):151-62.
57. Wang M, Zheng XF, Jiang LS. Efficacy and safety of antifibrinolytic agents in reducing perioperative blood loss and transfusion requirements in scoliosis surgery: a systematic review and meta-analysis. PLoS ONE [Electronic Resource]. 2015;10(-9):e0137886-e.
58. Wang HY, Hong SK, Duan Y, Yin HM. Tranexamic acid and blood loss during and after cesarean section: a meta-analysis. Journal of Perinatology. 2015;35(-10):818-25.
59. Wang H, Shen B, Zeng Y. Blood loss and transfusion after topical tranexamic acid administration in primary total knee arthroplasty. Orthopedics. 2015;38(-11):e1007-16.
60. Wang C, Xu GJ, Han Z, Ma JX, Ma XL, Jiang X, et al. Topical application of tranexamic acid in primary total hip arthroplasty: A systemic review and meta-analysis. International Journal Of Surgery. 2015;15:134-9.
61. van Galen KP, Engelen ET, Mauser-Bunschoten EP, van Es RJ, Schutgens RE. Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions. Cochrane Database of Systematic Reviews. 2015(-12):CD011385-CD.
62. Shemshaki H, Nourian SM, Nourian N, Dehghani M, Mokhtari M, Mazoochian F. One step closer to sparing total blood loss and transfusion rate in total knee arthroplasty: a meta-analysis of different methods of tranexamic acid administration. Archives of Orthopaedic & Trauma Surgery. 2015;135(4):573-88.
63. Sentilhes L, Lasocki S, Ducloy-Bouthors AS, Deruelle P, Dreyfus M, Perrotin F, et al. Tranexamic acid for the prevention and treatment of postpartum haemorrhage. British Journal of Anaesthesia. 2015;114(-4):576-87.
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66. Novikova N, Hofmeyr GJ, Cluver C. Tranexamic acid for preventing postpartum haemorrhage. Cochrane Database of Systematic Reviews. 2015(-6):CD007872-CD.
67. Marti-Carvajal AJ, Anand V, Sola I. Treatment for disseminated intravascular coagulation in patients with acute and chronic leukemia. Cochrane Database of Systematic Reviews. 2015(-6):CD008562-CD.
68. Ker K, Roberts I. Exploring redundant research into the effect of tranexamic acid on surgical bleeding: further analysis of a systematic review of randomised controlled trials. BMJ Open. 2015;5(-8):e009460-e.
69. Karanth L, Barua A, Kanagasabai S, Nair S. Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. Cochrane Database of Systematic Reviews. 2015(-9):CD009824-CD.
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71. He P, Zhang Z, Li Y, Xu D, Wang H. Efficacy and safety of tranexamic acid in bilateral total knee replacement: a meta-analysis and systematic review. Medical Science Monitor. 2015;21:3634-42.
72. Cheriyan T, Maier SP, 2nd, Bianco K, Slobodyanyuk K, Rattenni RN, Lafage V, et al. Efficacy of tranexamic acid on surgical bleeding in spine surgery: a meta-analysis. Spine Journal: Official Journal of the North American Spine Society. 2015;15(-4):752-61.
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Health Research Classification System category Generic Health Relevance
Extra information provided by this PSP
Original uncertainty examples Antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease. Implications for research: This updated Cochrane review has identified the need for well-designed, adequately powered randomised clinical trials to assess the benefits and harms of antifibrinolytic amino acids in people with upper gastrointestinal bleeding due to acute or chronic liver disease. According to Brown 2006, questions such as the following could be answered using randomised clinical trials. What regimen is most effective: single or combined? When can intravenous antifibrinolytic regimens be switched to oral administration? The randomised clinical trials should include participant-relevant clinical outcomes such as mortality, failure to control bleeding, and adverse events. Potential trials should be planned according to SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement (Chan 2013a; Chan 2013b). The trials should be reported according to the CONSORT (CONsolidated Standards Of Reporting Trials) statement (Moher 2010), which helps in improving the quality of reporting of benefits and harms in clinical research (Ioannidis 2004; Moher 2010). Trials should include participant-centred outcomes such as mortality, re-bleeding, and serious and non-serious adverse events as recommended by the Patient-Centered Outcomes Research Institute (P-CORI) statement (Selby 2013; Frank 2014; Selby 2014). ~ What are the best methods of preventing/reducing haemorrhage during myomectomy? ~ What are the risks and benefits of tranexamic acid when trying to avoid blood transfusion for hip fracture surgery?
Submitted by 1 relative or carer of blood recipient ~ 5 blood donors ~ 9 health professionals ~ 2 unknown ~ 7 other (question not from survey)
PSP information
PSP unique ID 0063
PSP name Blood Transfusion and Blood Donation
Total number of uncertainties identified by this PSP 51 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 28 February 2018