The role of tranexamic acid in a comprehensive blood management protocol for total hip and knee arthroplasty patients

Allogeneic blood transfusions during total hip or knee arthroplasty have been associated with increased risks for perioperative complications as well as increased medical costs. A multi-modal approach toperioperative management of the patients to minimize the risk for an allogeneic blood transfusion can help both the patient and the health care system. This approach involves optimizing the patients’ hemoglobin preoperatively, utilizing a variety of techniques intraoperatively including tranexamic acid to minimize blood loss, and using patient specific transfusion triggers post-operatively. In particular, the incorporation of tranexamic acid to the perioperative management of total hip and total knee replacement patients dramatically decreased the rate of allogeneic blood transfusions in our hospital.