RECOMBINANT-HUMAN-ERYTHROPOIETIN AS ADJUVANT TREATMENT FOR AUTOLOGOUSBLOOD DONATION IN ELECTIVE SURGERY WITH LARGE BLOOD NEEDS (GREATER-THAN-OR-EQUAL-TO-5 UNITS) - A RANDOMIZED STUDY

BACKGROUND: Autologous blood transfusion presents no infectious or imm unologic side effects. The aim of this randomized study was to determi ne the impact of recombinant human erythropoietin (rHuEPO) on the dona tion of 5 units of autologous blood by nonanemic patients who were can didates for elective surgery with transfusion requirements of greater than or equal to 5 units. STUDY DESIGN AND METHODS: Starting on Day -3 5, 420 mt of blood was taken weekly. All patients received 200 mg of i ron saccharose complex intravenously at each visit and six subcutaneou s injections of rHuEPO (141 U/kg) or placebo between Days -21 and -7. RESULTS: Of 50 patients, 45 completed the study (placebo, 21; rHuEPO, 24). Total red cell production was higher in the rHuEPO group (p = 0.0 01). Donation of 5 units was possible for 67 percent (placebo group) a nd 79 percent (rHuEPO group) of patients (p = 0.5). The mean number of blood units donated was 4.6 (placebo group) and 4.7 (rHuEPO group). M ore patients in the placebo group received allogeneic blood (9/21 [43% ] vs. 6/23 [26%]), although the difference did not reach significance (p = 0.34). CONCLUSION: In nonanemic patients donating 5 units of bloo d, rHuEPO associated with intravenous iron increased total red cell pr oduction. However. no difference was found between the rHuEPO and plac ebo groups with regard to the number of units of autologous blood dona ted or the number of patients receiving allogeneic blood transfusion.