ArticleBlood advances2019
Tranexamic acid modulates the immune response and reduces postsurgical infection rates.
Article in Blood advances, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 54 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Tranexamic Acid to Reduce Infection After Gastrointestinal Surgery; The TRIGS Trial
Tranexamic Acid Usage in Bilateral Mastectomy to Reduce Post-surgical Drainage
Who cites it
54 citing papers in PubMed, 3 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- Repurposing tranexamic acid as an anticancer drug: a systematic review and meta-analysis.Journal of cancer research and clinical oncology · 2025Pooled it
- Tranexamic acid administration for the prevention of periprosthetic joint infection and surgical site infection: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Effects of interventions targeting the systemic inflammatory response to cardiac surgery on clinical outcomes in adults.The Cochrane database of systematic reviews · 2023Pooled it
- The Immunologic Effect of Early Intravenous Two and Four Gram Bolus Dosing of Tranexamic Acid Compared to Placebo in Patients With Severe Traumatic Bleeding (TAMPITI): A Randomized, Double-Blind, Placebo-Controlled, Single-Center Trial.Frontiers in immunology · 2020Trial
- Safety and Efficacy of Tranexamic Acid in Liposuction: A Review of Current Literature.Aesthetic plastic surgery · 2026Review
- Tranexamic acid utilization remains low in anatomical and reverse total shoulder arthroplasty despite decreased postoperative complications: A propensity-matched analysis.Shoulder & elbow · 2026Article
- Article
- Fibrinolysis-unrelated functions of the plasminogen/plasmin system: A gateway to successful parasitism?Current research in parasitology & vector-borne diseases · 2026Review
- Tranexamic Acid for Acute Upper Respiratory Tract Infection-Associated Sore Throat Pain: A Randomized Controlled Trial.Journal of general and family medicine · 2026Article
- A clinical prediction model for postoperative delirium following surgical treatment of femoral fractures in older adult patients: development and validation study.BMC anesthesiology · 2025Article
- Tranexamic Acid and Systemic Complement Activation in Traumatic Brain Injury Patients.Journal of the American College of Surgeons · 2025Article
- Beyond Hemostasis: Exploring Intra-articular Tranexamic Acid's Analgesic Effect in Post-operative Care in Total Knee Arthroplasty - Original Article.Journal of orthopaedic case reports · 2025Article
- A retrospective observational study of risk factors for postoperative meningitis following resection of meningioma.The Journal of international medical research · 2025Observational
- Tranexamic acid inhibits group A streptococci-mediated fibrinolysisFrontiers in immunology · 2025Article
- Mediastinal infections: diagnostic and therapeutic advances from traditional surgery to novel minimally invasive techniques.Frontiers in medicine · 2025Review
- Application and research progress of tranexamic acid in the perioperative period of posterior lumbar interbody fusion.Frontiers in medicine · 2025Review
- Association between IV and topical tranexamic acid use and periprosthetic joint infections in hip and knee arthroplasty: a retrospective study.BMC musculoskeletal disorders · 2024Article
- An additional intra-operative peri-articular tranexamic acid decreases the drain output but does not benefit in total blood loss conservation during bilateral Total Knee Arthroplasty: A retrospective observation.Journal of clinical orthopaedics and trauma · 2024Article
- Article
- Usage of Tranexamic Acid for Total Hip Arthroplasty: A Matched Cohort Analysis of 144,344 Patients.Journal of clinical medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Tranexamic acid (TXA) is an antifibrinolytic agent that blocks plasmin formation. Because plasmin is known to promote inflammatory and immunosuppressive responses, we explored the possibility that plasmin-mediated immunosuppression in patients undergoing cardiac surgery can be directly reversed by TXA and decrease postoperative infection rates. The modulatory effect of TXA on inflammatory cytokine levels and on innate immune cell activation were evaluated with multiplex enzyme-linked immunosorbent assay and flow cytometry, respectively. Postoperative infection rates were determined in patients undergoing cardiac surgery and randomized to TXA (ACTRN12605000557639; http://www.anzca.edu.au). We demonstrate that TXA-mediated plasmin blockade modulates the immune system and reduces surgery-induced immunosuppression in patients following cardiac surgery. TXA enhanced the expression of immune-activating markers while reducing the expression of immunosuppressive markers on multiple myeloid and lymphoid cell populations in peripheral blood. TXA administration significantly reduced postoperative infection rates, despite the fact that patients were being administered prophylactic antibiotics. This effect was independent of the effect of TXA at reducing blood loss. TXA was also shown to exert an immune-modulatory effect in healthy volunteers, further supporting the fibrin-independent effect of TXA on immune function and indicating that baseline plasmin levels contribute to the regulation of the immune system in the absence of any comorbidity or surgical trauma. Finally, the capacity of TXA to reduce infection rates, modulate the innate immune cell profile, and generate an antifibrinolytic effect overall was markedly reduced in patients with diabetes, demonstrating for the first time that the diabetic condition renders patients partially refractory to TXA.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.