Efficacy of recombinant erythropoietin for stimulating erythropoiesis after blood loss and surgery. An experimental study in rats.
Perioperative administration of recombinant human erythropoietin (rEpo) may reduce the need for allogeneic blood transfusions by diminishing the time lag between blood loss and erythropoiesis and by generating more adequate Epo levels. The efficacy of pre- and postoperative rEpo was studied in rats subjected to blood loss (20% of the blood volume) and surgery (ileal resection). After 200 U rEpo/kg daily for 5 days postoperatively, hemoglobin had increased by 15.7 g/l in these rats but by 36.9 g/l in rEpo-treated controls without surgery (p less than 0.05), indicating an inhibitory effect of surgery on erythropoiesis. A course of 200 U rEpo/kg/day for 5 days, starting 4 or 2 days before operation and blood loss, resulted in significantly higher postoperative hemoglobin levels than in untreated controls. Such difference did not occur if rEpo treatment was begun on the day of operation. Prolonged (10-day) postoperative rEpo treatment was of minor benefit, inducing significant increase in hemoglobin and hematocrit only from day 8 onwards. The study indicates that rEpo is a promising agent to obviate need for perioperative blood transfusions, provided that the treatment is begun before operation.
Department of Surgery, Erasmus University, Rotterdam, The Netherlands.
M A
MA
Hoynck van Papendrecht
H
H
Jeekel
O R
OR
Busch
R L
RL
Marquet
D000818:Animals; D004305:Dose-Response Relationship, Drug; D004920:Erythropoiesis / Q000187:drug effects*; D004921:Erythropoietin / Q000627:therapeutic use*; D006400:Hematocrit; D006454:Hemoglobins / Q000187:drug effects / Q000378:metabolism; D006470:Hemorrhage / Q000628:therapy*; D007082:Ileum / Q000187:drug effects / Q000601:surgery; D008297:Male; D011182:Postoperative Care; D011300:Preoperative Care; D051381:Rats; D011914:Rats, Inbred BN; D011994:Recombinant Proteins / Q000627:therapeutic use
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin