Effectiveness of erythropoietin for cardiovascular surgery to prevent homologous blood transfusions
Konishi, T.; Kaneko, T.; Ohbayashi, T.; Ohki, T.; Watanabe, Y.; Fuse, K.
Nihon Kyobu Geka Gakkai 41(2): 187-192
1993
ISSN/ISBN: 0369-4739 PMID: 8473781 Document Number: 421246
Erythropoietin (EPO) was used preoperatively in 109 cardiovascular surgery cases to prevent homologous blood transfusions. Operative procedures in all these cases were coronary artery bypass grafting in 80 cases, valve replacement in 14, and a few cases of aortic vascular replacement or others, aging about average 62 years and weighing about average 54 kg. EPO was administered concomitantly with oral iron sulfate in the following three different manners; 100 units per body weight daily intravenously, 300 U./B.W. twice in a week intravenously, and 600 U./B.W. once in a week subcutaneously. Autologous blood donations were also performed as long as the blood hemoglobin levels were over 12 (g/dl) and repeated until the date of operation, and these blood deposits were returned to each patient at the time of operation. The blood hemoglobin level had increased on average from 12.6 (+/- 1.5 SD) to 13.6 (+/- 1.2 SD) after 23 days (+/- 13 SD) administration of EPO, while autologous blood deposit of 536 ml (+/- 353 SD) was obtained. Homologous blood transfusions were unnecessary in 89% of all cases, especially good in 96.7% of the group with over 12 of hemoglobin level before EPO administration. However, it remained within 79.6% of those with lesser to 12, so there was still room for improvement in this anemic group. No adverse effects were recognized in all cases. It was concluded that preoperative use of EPO is efficient to promote autologous blood donation, and its application will be expanded to anemic cases. EPO could offer an excellent means of preventing homologous blood transfusion. Further study concerning the appropriate application of erythropoietin seems to be required.