Potential role of recombinant human erythropoietin in the peri-surgical setting

Abstract

For patients participating in autologous blood programs, one factor influencing the likelihood of homologous blood exposure is the number of available autologous units. To study the role of human recombinant erythropoietin (rhEpo) in increasing the amount of autologous blood that can be obtained prior to surgery, we conducted a randomized double-blind controlled trial of rhEpo in 47 adult patients scheduled for elective orthopedic procedures. Patients received either rhEpo (600 U/kg) or placebo i.v. twice weekly over a 21-day study period, during which up to six units of blood were collected. Patients were deferred from donation for hematocrit less than 34%. All patients received FeSO4, 325 mg orally three times daily. The mean number of units collected was 5.4 +/- 0.2 and 4.1 +/- 0.2 (mean +/- SE) for the rhEpo and placebo patients, respectively. Mean red blood cell volume donated by rhEpo patients was 41% greater than placebo patients (961 ml vs. 683 ml, p less than 0.05) Only one of 23 patients (4%) treated with rhEpo were unable to donate greater than or equal to 4 U, compared to seven of 24 (29%) placebo patients. No adverse effects were attributed to rhEpo. We conclude that rhEpo is efficacious in increasing autologous blood donated in elective surgical patients.

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