title: Preoperative use of epoietin beta in total hip replacement: a prospective study.
abstract: OBJECTIVE
  Epoietin (EPO) effectively decreases perioperative blood transfusion requirements. We evaluated the feasibility of using EPO beta to increase haemoglobin levels before total hip replacement (THR) and reduce transfusion.
  
  
  METHODS
  One hundred and seventy-one patients undergoing primary THR were included in this prospective observational study. Patients with initial haemoglobin level <130 g l−1 received EPO beta subcutaneously in a four-dose regimen. Haemoglobin levels were measured at baseline, before surgery, and at postoperative days 1 and 5.
  
  
  RESULTS
  Twenty-eight patients received EPO beta preoperatively, 143 were not treated including 42 with initial haemoglobin level <130 g l−1. Haemoglobin increased by 29 ± 9 g l−1 in the low Hb + EPO group versus 2 ± 1 g l−1 for the other patients. In the low Hb + EPO group 3.6% were transfused, in the low HB group 45.2% (P = 0.001) and in the normal Hb group 11.9% (P = 0.2).
  
  
  CONCLUSIONS
  Preoperative EPO beta increases haemoglobin level and reduces transfusion frequency in anaemic patients before total joint replacement. It could play a major role in the management of perioperative blood loss in orthopaedic surgery.
authors.affiliation: Service de Chirurgie Orthopédique et Traumatologique, CHU de Rangueil, TSA 50032, 1, avenue Jean Poulhès, 31059 Toulouse Cedex 9, France. jean-michel.laVosse@wanadoo.fr
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Laffosse
authors.forename: Vincent
authors.initials: V
authors.lastname: Minville
authors.forename: Philippe
authors.initials: P
authors.lastname: Chiron
authors.forename: Aline
authors.initials: A
authors.lastname: Colombani
authors.forename: Claude
authors.initials: C
authors.lastname: Gris
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Pourrut
authors.forename: Bernard
authors.initials: B
authors.lastname: Eychenne
authors.forename: Olivier
authors.initials: O
authors.lastname: Fourcade