Combination of erythropoietin and tranexamic acid in bilateral simultaneous total hip arthroplasty: a randomised, controlled trial.
BACKGROUND
This study aimed to evaluate whether the combination of erythropoietin (EPO) and tranexamic acid (TXA) exerted any additional benefits on the number of blood transfusions required and haematological parameters compared with TXA alone following primary bilateral simultaneous total hip arthroplasty.


METHODS
We conducted a single-centre, prospective, randomised, and controlled trial at our hospital. Group EPO + TXA (n = 30) received daily subcutaneous injections EPO (10,000 IU) on preoperative days 1-4 and postoperative days 1-3. Additionally, these patients were administered TXA (15 mg/kg) 10 min prior to the incision. Group TXA (n = 32) received only TXA (15 mg/kg) 10 min prior to the incision. The primary outcomes were the haematological parameters and number of blood transfusions required. The secondary outcomes were total blood loss, drainage volume, and postoperative complications.


RESULTS
The total amount of blood transfusion and mean blood transfusion per patient was lower in group EPO + TXA than in group TXA (p = 0.039, p = 0.023; respectively). In the postoperative period, patients in group EPO + TXA had higher haematological parameters (haemoglobin, haematocrit, and reticulocyte count) than patients in group TXA. No significant differences were found in total blood loss, drainage volume, and DVT or PE between the 2 groups.


CONCLUSIONS
This study showed that administrating EPO + TXA in combination can increase haematological parameters and reduce the need for blood transfusion without increasing the risk of DVT or PE compared with TXA alone.
Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
Yuan-Gang
YG
Wu
Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
Yi
Y
Zeng
Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
Bin
B
Shen
Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
Hai-Bo
HB
Si
Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
Fei
F
Cao
Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
Ti-Min
TM
Yang
Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
Fu-Xing
FX
Pei
D000328:Adult; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip; D001772:Blood Cell Count; D001803:Blood Transfusion; D004359:Drug Therapy, Combination; D004909:Erythrocyte Indices; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D005271:Femur Head Necrosis / Q000097:blood / Q000601:surgery*; D006617:Hip Dislocation / Q000097:blood / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000097:blood / Q000601:surgery*; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage*
D000933:Antifibrinolytic Agents; D004921:Erythropoietin; D014148:Tranexamic Acid