Effect of treatment with tranexamic acid on complement activation and ischemia reperfusion in liver transplantation in pigs.

COMPLEMENT is gradually being considered in ischemia-reperfusion, especially in xenotransplantation. Reperfusion injury is characterized by deposition of C3 and C5b-9. Complement inhibitors are used in amelioration of warm ischemia and rejection episodes. Tranexamic acid (Amca), a synthetic antifibrinolytic agent, has proven to be effective in acquired angioedema (a deficiency of the C1 inhibitor [Ci-inh]). Because of the increased risk of severe fibrinolysis, Amca is often used during orthotopic liver transplantation (OLT). Although no report of the use of Amca was found in the treatment of ischemia-reperfusion injury, the anticomplement effect of Amca has been demonstrated. Our aim was to study the complement activation and the effect of Amca on complement and ischemia-reperfusion injury in a liver allograft with donor warm ischemia.