The efficacy and safety of ɛ-aminocaproic acid treatment in patients with cirrhosis and hyperfibrinolysis


Dr B. A. Runyon, Loma Linda University Medical Center, 11234 Anderson Street, Room 1556, Loma Linda, CA 92354, USA.




Patients with decompensated cirrhosis are at risk for hyperfibrinolysis; this is potentially fatal. ɛ-aminocaproic acid has been used to treat patients with hyperfibrinolysis; however, the data about its benefit in the setting of cirrhosis are minimal.


To analyse the efficacy of ɛ-aminocaproic acid and its safety in cirrhotic patients with hyperfibrinolysis.


All patients with an abnormal euglobin lysis time who were admitted to Rancho Los Amigos Medical Center from 1 January 2001 to 31 December 2002 were included in the study. Their medical records were reviewed and analysed.


There were 60 cirrhotic patients with shortened euglobin lysis time. Fifty-two patients received ɛ-aminocaproic acid. Of the 52 patients, seven had one or more bleeding episodes with the subcutaneous or soft tissue bleeding as the most common indication for ɛ-aminocaproic acid use. Of the 37 patients, 34 (92%) had improvement or resolution of their bleeding. Only two (3%) patients had ɛ-aminocaproic acid treatment discontinued because of minor side effects, rash and lightheadedness. There were no thromboembolic complications of treatment.


ɛ-aminocaproic acid was found to be effective and safe for treatment of hyperfibrinolysis in patients with cirrhosis.