Corewell Health West
To determine if endobronchial (topical) tranexamic acid used prophylactically prior to performing transbronchial biopsies in lung transplant recipients reduces bleeding risk.
Tranexamic acid (TXA) is an antifibrinolytic agent. It forms a reversible complex that displaces plasminogen from fibrin resulting in inhibition of fibrinolysis. It also inhibits proteolytic activity of plasmin. TXA is frequently used in clinical practice and can be administered via multiple delivery methods, including intravenous, nebulized, and topical. It has been shown to reduce blood loss in a variety of clinical settings without significant adverse effects. It has also been evaluated for prophylactic use with mixed results in reducing bleeding. In our current general pulmonary practice,…
Inclusion Criteria: 1. Single or double lung transplant recipients 2. Patients \>18 years old 3. Willingness and ability to sign an informed consent for study participation Exclusion Criteria: 1. Platelet count (\<50k/uL) 2. INR (\>1.6) 3. Active bleeding 4. Decompensated liver disease 5. History of uremic bleeding or BUN \>50 6. Severe pulmonary hypertension (mean PA pressure \>40 mmHg on RHC or estimated PA systolic pressure \>62 mmHg on TTE within one year of procedure) 7. Known bleeding disorder 8. Allergy to TXA 9. Prior history of severe TBBx-related airway bleeding requiring admissio…
Endobronchial (topical) tranexamic acid used prophylactically prior to performing transbronchial biopsies in lung transplant recipients
Topical Saline (placebo) administered as endobronchial topical application prior to performing transbronchial biopsies in lung transplant recipients.
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