title: Effectiveness of very low doses of subcutaneous recombinant human erythropoietin in facilitating autologous blood donation before orthopedic surgery.
abstract: BACKGROUND
  Clinical and pharmacokinetic data suggest that very low doses of subcutaneous recombinant human erythropoietin (rHuEPO) may be effective in a preoperative autologous blood deposit program.
  
  
  METHODS
  Fifty-two patients, scheduled for orthopedic surgery, were enrolled in a double-blind and placebo-controlled study. Patients were randomly assigned to the placebo group or to receive 30, 60, or 100 IU per kg of rHuEPO subcutaneously twice a week for 2 weeks before surgery. The dose of rHuEPO that was effective in facilitating the collection of 4 units of blood in the 2 weeks before surgery and that prevented a sharp decrease in hematocrit was determined.
  
  
  RESULTS
  Only in patients receiving 100 IU per kg of rHuEPO did the outcome measurements differ significantly from those in the placebo group. With a higher (p < 0.01) cumulative increase in red cell volume during the study period (297 +/- 127 vs. 121 +/- 44 mL), 64 percent of those receiving 100 IU per kg of rHuEPO were able to donate 4 units of blood for autologous use, as compared with 23 percent of the placebo group (p < 0.05). Allogeneic transfusion was avoided, and the preoperative hematocrit and reticulocyte count were significantly higher in the patients receiving 100 IU per kg of rHuEPO (p < 0.05 and p < 0.01, respectively).
  
  
  CONCLUSIONS
  Subcutaneously administered rHuEPO at a dose of 100 IU per kg twice a week for 2 weeks is effective in facilitating the collection of blood for autologous use and may improve the cost-benefit ratio of blood conservation interventions. Doses < or = 60 IU per kg are ineffective in facilitating such collections in this surgical setting.
authors.affiliation: Hospital Mora d'Ebre, Reus, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Sans
authors.forename: C
authors.initials: C
authors.lastname: Bofil
authors.forename: J
authors.initials: J
authors.lastname: Joven
authors.forename: X
authors.initials: X
authors.lastname: Clivillé
authors.forename: J M
authors.initials: JM
authors.lastname: Simó
authors.forename: X
authors.initials: X
authors.lastname: Llobet
authors.forename: A
authors.initials: A
authors.lastname: Peró
authors.forename: J
authors.initials: J
authors.lastname: Galbany
mesh_terms: D000368:Aged; D001804:Blood Transfusion, Autologous / Q000379:methods*; D004920:Erythropoiesis / Q000187:drug effects; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006400:Hematocrit; D006615:Hip / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D007279:Injections, Subcutaneous; D007717:Knee / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D017701:Reticulocyte Count
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin