title: Efficacy of preoperative donation of autologous blood in patients undergoing radical retropubic prostatectomy.
abstract: BACKGROUND
  Radical retropubic prostatectomy (RRP) has resulted in substantial blood loss and the frequent need for homologous blood transfusion. In this study, the efficacy of autologous blood transfusion, from medical and financial perspectives, was evaluated in patients undergoing RRP.
  
  
  METHODS
  Between 1994 and 2000, 80 patients with localized prostate cancer underwent RRP in our institute. Based on informed consent, preoperative donation of autologous blood (PDA) was performed in 65 out of 80 patienets. Four or six units were donated during the first 3 years; however, donation units were reduced to a maximum of 4 units since 1997 onwards. The discard rate of donated blood and frequency of homologous transfusion were examined. Changes of hematocrit (Ht) and hemoglobin (Hb) levels through donation and surgery and important factors that may affect postoperative levels of Ht and Hb were evaluated in 56 patients receiving 4-unit donations.
  
  
  RESULTS
  Overall, 2 or 4 units of donated blood were discarded in four patients and homologous transfusion was required in two patients. In 56 patients receiving 4-unit donation, the mean Ht level at predonation was 43.3%. Following donation, this decreased to 35.7%. The administration of recombinant human erythropoietin (rHuEpo) relieved declining Ht levels following donation, but changes in Ht levels after surgery were minor. Important factors related to postoperative decline of Ht and Hb levels were operative time and blood loss.
  
  
  CONCLUSIONS
  The program of 4-unit PDA can be performed safely without rHuEpo injection, and it is useful to reduce the risk of requiring homologous transfusion. However, more efficient programs to relieve patient burden and to reduce medical cost are needed.
authors: Department of Urology, Kawasaki Medical School, Kurashiki, Japan. moriokam@med.kawasaki-m.ac.jp
authors: Masaaki
authors: M
authors: Morioka
authors: Tokunori
authors: T
authors: Yamamoto
authors: Yoji
authors: Y
authors: Furukawa
authors: Keigo
authors: K
authors: Kinugawa
authors: Atsushi
authors: A
authors: Sone
authors: Yoshimasa
authors: Y
authors: Jo
authors: Takakazu
authors: T
authors: Matsuki
authors: Takashi
authors: T
authors: Nakajima
authors: Takao
authors: T
authors: Koide
authors: Hiroyoshi
authors: H
authors: Tanaka
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D004921:Erythropoietin / Q000008:administration & dosage*; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000601:surgery*; D011994:Recombinant Proteins
chemical_list: D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin