The HeLiX Trial: A Randomized Controlled Trial of Tranexamic Acid Versus Placebo to Reduce Perioperative Blood Transfusion in Patients Undergoing Liver Resection

Liver resection is the optimal treatment for patients with liver tumors. Despite improvements in preoperative imaging and evaluation of liver functional reserve, intraoperative blood loss remains a major risk factor for postoperative complications and long-term survival. Furthermore, packed red blood cells are limited in supply and there are a number of risks specific to receiving blood transfusion. Several strategies to reduce blood loss during liver resection have been developed and tested including operative and non-operative interventions. Despite these improvements, bleeding remains a problem during major liver resection with up to 30% of patients receiving blood products. Thus, further interventions to reduce bleeding and blood transfusion during liver surgery are sorely needed. Tranexamic Acid (TXA) is a drug that decreases bleeding and blood transfusion in a number of settings, including multisystem trauma, orthopaedic surgery, and cardiac surgery. In Canada, TXA is rarely used in patients undergoing liver surgery. This grant will support a multicentre, blinded, definitive RCT examining the impact of TXA on blood transfusion in patients undergoing liver resection.