Concentration-Effect Relationship for Tranexamic Acid Inhibition of Tissue Plasminogen Activator-Induced Fibrinolysis In Vitro Using the Viscoelastic ClotPro TPA-Test

( Br J Anaesth . 2024;132(2): 343–351. DOI: 10.1016/j.bja.2023.09.027) Pregnancy increases the level of procoagulant activity within the body, yet postpartum hemorrhage (PPH) still affects a significant portion of births (1% to 3%) worldwide. Tranexamic acid (TXA) is a drug targeting the processes of fibrinolytic activity at the cellular level, which has also been seen to reduce bleeding of the uterus, when administered to obstetrical patients experiencing PPH. Recently, within both orthopedic and surgery patients the ClotPro TPA-test has been shown to indicate downregulation of fibrinolysis following TXA administration. The authors of this study hypothesize that this test can also be used to assess TXA efficacy in obstetrical patients, specifically with a dose-dependent effect of TXA on fibrinolytic activity.