Tranexamic Acid Yields Lower Incidence of Red-Cell Transfusion in Noncardiac Surgery

WEDNESDAY, June 17, 2026 (HealthDay News) — A hospital policy of tranexamic acid administration among patients undergoing major noncardiac surgery results in a lower incidence of red-cell transfusion than placebo administration and is noninferior with respect to a diagnosis of venous thromboembolism, according to a study published online June 10 in the New England Journal of Medicine.

Brett L. Houston, M.D., Ph.D., from the University of Manitoba in Winnipeg, Canada, and colleagues conducted a multicenter, double-blind trial involving patients undergoing noncardiac surgery who had a high risk for red-cell transfusion. Ten Canadian hospitals were randomly assigned at four-week intervals to a hospital-wide policy of intraoperative tranexamic acid or placebo. Transfusion of red cells during the index hospitalization and diagnosis of venous thromboembolism within 90 days were the coprimary effectiveness and safety outcomes.

A total of 8,273 patients could be evaluated for the coprimary outcomes; 60.5 percent of the surgical procedures were oncologic surgery. The researchers found that the percentage of patients who received a red-cell transfusion during hospitalization was 7.4 and 9.8 percent in the tranexamic acid and placebo groups, respectively (relative risk, 0.73; 95 percent confidence interval, 0.61 to 0.86). Venous thromboembolism within 90 days occurred in 2.1 and 2.1 percent of patients in the tranexamic acid and placebo groups, respectively (relative risk, 0.96; 95 percent confidence interval, 0.65 to 1.38), meeting the criterion for noninferiority.

“This is transformative to patient care and globally has the potential to save millions of units of red blood cells each year,” Houston said in a statement.

Several authors disclosed ties to the pharmaceutical industry.

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