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Oral or intravenous iron as an adjuvant to autologous blood donation in elective surgery: a randomized, controlled study
Author(s) -
Weisbach V.,
Skoda P.,
Rippel R.,
Lauer G.,
Glaser A.,
Zingsem J.,
Zimmermann R.,
Eckstein R.
Publication year - 1999
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.1537-2995.1999.39050465.x
Subject(s) - medicine , phlebotomy , donation , intravenous iron , hemoglobin , randomized controlled trial , surgery , autologous blood , blood transfusion , elective surgery , blood donor , anesthesia , anemia , iron deficiency , immunology , economics , economic growth
BACKGROUND: This study was performed to evaluate the capacity of oral and intravenous (IV) iron administration during autologous blood donation (ABD) to improve the efficacy of ABD and to prevent the need for allogeneic blood transfusion in patients without iron deficiency who are undergoing major elective surgery for which a minimum of 3 autologous units have been ordered. STUDY DESIGN AND METHODS: One hundred twenty‐three patients were enrolled in an open‐labeled, randomized, controlled trial and assigned to three treatment groups: patients in Group 1 received 3 × 100 mg of Fe 2+ per day given orally for 5 weeks before operation; patients in Group 2 received 200 mg of Fe 3+ given intravenously after each donation combined with initial IV iron supplementation in patients with hemoglobin under 15 g per dL; and patients in Group 3 were in the control group that received no iron medication. A modest ABD program involving weekly phlebotomy and threshold hemoglobin values for donation of 11.5 g per dL in women and 12.0 g per dL in men was performed. RESULTS: Ninety patients, 15 women and 15 men in each of the three groups, completed the study. The mean net red cell production during ABD was no higher (p>0.2) in the iron‐treated groups (Group 1: 473 ± 178 mL; Group 2: 436 ± 170 mL; Group 3 (controls): 397 ± 174 mL). The mean number of autologous units donated per patient did not differ (p>0.7) among the groups (Group 1: 3.1 ± 0.6; Group 2: 2.9 ± 0.7; Group 3: 3.0 ± 0.7). The proportion of patients who needed allogeneic blood transfusion showed no significant (p>0.4) advantage for iron treatment, (Group 1: 7%; Group 2: 20%; Group 3: 10%). CONCLUSION: In non‐iron‐deficient patients undergoing modest ABD without erythropoietin therapy, neither oral nor IV application of iron during the preoperative period enhances the success of preoperative ABD.