The Minimal Effective Dosage of Recombinant Human Erythropoietin for Preoperative Autologous Donation.

Do,  Sang hwan; Lim,  Young jin; Cho,  Hyun sung; Lee,  Ji ho; Yoon,  Jong hyun; Ham,  Byung moon

doi:1996.31.5.640

Korean Journal of Anesthesiology 1996;31(5):640-644.
DOI: https://doi.org/10.4097/kjae.1996.31.5.640

Sang hwan Do, Young jin Lim, Hyun sung Cho, Ji ho Lee, Jong hyun Yoon, Byung moon Ham

¹Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.
²Department of Orthopedic Surgery, Boramae City Hospital, Seoul, Korea.
³Department of Clinical Pathology, Boramae City Hospital, Seoul, Korea.

Abstract

BACKGROUND
Preoperative autologous donation is one of the most widely used methods of autotransfusion. However donation of predetermined units cannot often be achieved because of falling hematocrit with donations going on. We studied on the minimal effective dosage of recombinant human erythropoietin(rhEPO) used in preoperative autologous donation.
METHODS
We conducted randomized trial of rhEPO in 45 adults for posterior spinal fusion procedures who had basal hematocrit less than 40 percent. The patients received either nothing(control group) or rhEPO(25 or 50 units/kg) intravenously twice a week for 21 days, during which time up to 3 units of blood was collected. Patients were excluded from donation when their hematocrit values were less than 33 percent. All patient received iron sulfate(256mg orally three times daily).
RESULTS
The mean number of units collected per patient(mean+/-SD) was 3+/-0 for the 50-unit group(P<0.05 when compared with control group), 2.84+/-0.36 for the 25-unit group and 2.67+/-0.49 for the control group. The red cell volume donated by the patients who received rhEPO(347 ml, 325 ml) was greater than that donated by the control group(255 ml, P<0.05). The differences between hematocrits of the first and the third preoperative donations were significantly less in 50-unit group(1.50+/-2.05) and 25-unit group(1.51+/-1.85) than that of control group(3.73+/-1.66). Two patients of the 25-unit group and 5 patients of the control group required additional homologous blood postoperatively. And there were no significant differences in the pattern of postoperative changes of hemoglobin and hematocrit among each group.
CONCLUSIONS
Fifty units per kilogram of body weight is considered appropriate to be the minimal effective dosage for preoperative autologous donation.

Key Words: Transfusion preoperative autologous donation; Hormone erythropoietin