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Effectiveness of very low doses of subcutaneous recombinant human erythropoietin in facilitating autologous blood donation before orthopedic surgery
Author(s) -
Sans T.,
Bofill C.,
Joven J.,
Clivillé X.,
Simó J.M.,
Llobet X.,
Peró A.,
Galbany J.
Publication year - 1996
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1996.36996420762.x
Subject(s) - medicine , hematocrit , erythropoietin , placebo , autologous blood , orthopedic surgery , surgery , blood transfusion , pharmacokinetics , anesthesia , alternative medicine , pathology
Background: Clinical and pharmacokinetic data suggest that very low doses of subcutaneous recombinant human erythropoietin (rHuEPO) may be effective in a preoperative autologous blood deposit program. Study Design and Methods: Fifty‐two patients, scheduled for orthopedic surgery, were enrolled in a double‐blind and placebo‐controlled study. Patients were randomly assigned to the placebo group or to receive 30, 60, or 100 IU per kg of rHuEPO subcutaneously twice a week for 2 weeks before surgery. The dose of rHuEPO that was effective in facilitating the collection of 4 units of blood in the 2 weeks before surgery and that prevented a sharp decrease in hematocrit was determined. Results: Only in patients receiving 100 IU per kg of rHuEPO did the outcome measurements differ significantly from those in the placebo group. With a higher (p < 0.01) cumulative increase in red cell volume during the study period (297 ± 127 vs. 121 ± 44 mL), 64 percent of those receiving 100 IU per kg of rHuEPO were able to donate 4 units of blood for autologous use, as compared with 23 percent of the placebo group (p < 0.05). Allogeneic transfusion was avoided, and the preoperative hematocrit and reticulocyte count were significantly higher in the patients receiving 100 IU per kg of rHuEPO (p < 0.05 and p < 0.01, respectively). Conclusion: Subcutaneously administered rHuEPO at a dose of 100 IU per kg twice a week for 2 weeks is effective in facilitating the collection of blood for autologous use and may improve the cost‐benefit ratio of blood conservation interventions. Doses ≤ 60 IU per kg are ineffective in facilitating such collections in this surgical setting.