[Preoperative use of erythropoietin (rH-EPO) and determination of optimal doses in patients with benign prostatic hypertrophy for future autologous blood transfusion].
BACKGROUND
Recently, autologous blood transfusion has been widely endorsed, because of the adverse effects attributed to homologous blood transfusion. We found that the administration of recombinant human erythropoietin (rH-EPO) permitted the preoperative collection of an adequate volume of autologous blood in a short period of time. This reduced or eliminated the need for homologous blood transfusion.


METHODS
To determine optimal dosage of rH-EPO, I conducted a randomized, controlled trial in 86 patients with benign prostatic hypertrophy (BPH) scheduled for transurethral resection of the prostate (TUR-P). The patients from whom approximately 10% of their total blood volume was removed, received six different doses of rH-EPO either intravenously or subctaneously. All patients received iron sulfate 100 mg orally once a day during the study.


RESULTS
I found that 9,000 IU of rH-EPO given intravenously daily or 10,500 IU of rH-EPO injected subcutaneously every third day for a week were optimal dosages. These schedules ennabled us to withdraw approximately 400 ml of blood prior to operation without adverse effects.


CONCLUSIONS
I conclude that the efficacy of rH-EPO is greater when administered subcutaneously rather than intravenously. It is clear that rH-EPO increases the ability of patients about to undergo selective surgery to donate greater amounts of blood for future autologous transfusion.
Inatsuchi
H
H
Department of Urology, Tokai University School of Medicine, Japan.
D000368:Aged; D001804:Blood Transfusion, Autologous / Q000379:methods*; D004921:Erythropoietin / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000601:surgery / Q000628:therapy*; D011994:Recombinant Proteins / Q000008:administration & dosage
D011994:Recombinant Proteins; D004921:Erythropoietin