Recombinant human erythropoietin for autologous blood donation: effects on perioperative red-blood-cell and serum erythropoietin production

• Published in: The Lancet (British edition) Vol. 339; no. 8796; pp. 773 - 775
• Main Authors: Tasaki, T., Ohto, H., Hashimoto, C., Abe, R., Saitoh, A., Kikuchi, S.
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 28.03.1992; Lancet; Elsevier Limited
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood; Blood Transfusion, Autologous - methods; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Bones; Erythrocytes; Erythrocytes - drug effects; Erythropoietin - biosynthesis; Erythropoietin - blood; Erythropoietin - therapeutic use; Female; Humans; Male; Medical research; Medical sciences; Middle Aged; Proteins; Recombinant Proteins - therapeutic use; Regression Analysis; Surgery; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transfusion; Erythropoietin; Red blood cell; Intraoperative; Serum; Autologous system; Resuscitation; Blood
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/0140-6736(92)91895-F

To speed collection of blood for autologous transfusion during elective surgery, patients may be given recombinant human erythropoietin (r-HuEPO). In a controlled trial, we evaluated the effects of r-HuEPO on perioperative red-blood-cell and serum erythropoietin (s-EPO) production in patients donating blood before elective orthopaedic surgery. Patients were assigned randomly to receive no r-HuEPO (12 patients), or 3000 U (4), 6000 U (5), or 9000 U (4) of r-HuEPO intravenously twice a week from the time of the first blood donation. All patients received iron sulphate. 1200 ml blood was collected from each patient in three weekly donations of 400 ml. The 3000, 6000, and 9000 U treatment groups produced 284, 350, and 383 ml, respectively, of red cells during donation, and the untreated controls produced 211 ml. s-EPO concentrations were within the normal range during donation. After surgery, s-EPO concentrations peaked on postoperative day 1 in untreated patients and on day 7 in treated patients; therefore, r-HuEPO may suppress endogenous erythropoietin secretion. Although administration of r-HuEPO increases production of red blood cells, the preoperative anaemia induced by repeated phlebotomy without r-HuEPO may accelerate the postoperative secretion of endogenous erythropoietin.