title: Effect of recombinant human erythropoietin on transfusion risk in coronary bypass patients.
abstract: BACKGROUND
  Patients having a cardiac operation frequently require allogeneic blood transfusions despite surgical blood-conservation techniques. Recombinant human erythropoietin (Epoetin alfa) may augment this conservation by stimulating erythropoiesis. The safety and efficacy of perioperative use of Epoetin alfa to reduce the need of allogeneic transfusion was studied.
  
  
  METHODS
  A multicenter double-blind, placebo-controlled, parallel-group study involved 182 patients having coronary artery bypass grafting and randomized to receive Epoetin alfa (300 or 150 IU/kg) or placebo subcutaneously for 5 days before, on the day of, and for 2 days after operation.
  
  
  RESULTS
  Perioperative Epoetin alfa resulted in greater increases in baseline to preoperative hemoglobin levels and hematocrit (300 IU/kg) and in presurgery to postsurgical day 1 reticulocyte counts versus placebo (p < or = 0.05). However, there was no significant difference in transfusion requirements. Incidences of adverse events were similar in all study groups.
  
  
  CONCLUSIONS
  Lower incidences of allogeneic blood exposure were observed in both Epoetin alfa-treated groups; however, the differences between all treatment groups were not significant. This was probably due to the relatively short 5-day preoperative course of Epoetin alfa therapy. There were no significant differences between the three groups relative to safety. Epoetin alfa was well tolerated in this population.
authors.affiliation: Cardiac Anesthesia Group, Massachusetts General Hospital, Boston 02114-2696, USA.
authors.forename: M N
authors.initials: MN
authors.lastname: D'Ambra
authors.forename: R J
authors.initials: RJ
authors.lastname: Gray
authors.forename: R
authors.initials: R
authors.lastname: Hillman
authors.forename: J W
authors.initials: JW
authors.lastname: Jones
authors.forename: H C
authors.initials: HC
authors.lastname: Kim
authors.forename: R
authors.initials: R
authors.lastname: Rawitscher
authors.forename: H
authors.initials: H
authors.lastname: Schnaper
authors.forename: I
authors.initials: I
authors.lastname: Szymanski
authors.forename: G J
authors.initials: GJ
authors.lastname: Vlahakes
authors.forename: D
authors.initials: D
authors.lastname: Kaplan
authors.forename: K E
authors.initials: KE
authors.lastname: Lynch
authors.forename: M
authors.initials: M
authors.lastname: Guilfoyle
authors.forename: R I
authors.initials: RI
authors.lastname: Abels
mesh_terms: D000906:Antibodies / Q000097:blood; D001803:Blood Transfusion; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins
chemical_list: D000906:Antibodies; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa