Herrick J. Siegel, M.D., professor in the Department of Orthopaedic Surgery, Matthew Hess, M.D., former chief resident in the Department of Orthopaedic Surgery, and Nicholas Andrews, M.D., current resident in the Department of Orthopaedic Surgery, are authors of a recently published article titled “Intravenous tranexamic acid decreases intraoperative transfusion requirements and does not increase incidence of symptomatic venous thromboembolic events in musculoskeletal sarcoma surgery.”

Being that tranexamic acid (TXA) has a perceived increased risk of venous thromboembolism (VTE), it is poorly studied in patients with bone and musculoskeletal sarcoma. This study, which was published in the October issue of Surgical Oncology, aims to “assess the safety and efficacy of intravenous (IV) TXA for patients undergoing surgical resection of primary bone or soft-tissue sarcoma.”

The study looked at 39 patients who did not receive TXA and 59 patients who did. Among those who did not receive TXA, two experienced pulmonary embolisms, but none of the TXA patients did. Giving TXA through an IV during surgery significantly reduced the chances of needing a blood transfusion during the operation and the amount of blood required if a transfusion was needed. Surgeries were also faster for TXA patients. Additionally, for a specific group of patients who had a particular type of surgery, TXA also reduced the need for blood transfusions and made the surgeries shorter.

In conclusion, giving at least 1 gram of TXA through an IV during sarcoma surgery can safely reduce the need for blood transfusions during the operation and decrease the amount of blood used if a transfusion is required.