Effectiveness of very low doses of subcutaneous recombinant human erythropoietin in facilitating autologous blood donation before orthopedic surgery

Sans, Teresa; Bofill, C; Joven, Jorge; Clivillé, X; Simó, Josep M.; Llobet, X.; Pero, Ana Carolina; Galbany, J. Auleda

doi:10.1046/j.1537-2995.1996.36996420762.x

Cited by 37 publications

(5 citation statements)

References 24 publications

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“…Clinical trials of ESA have also demonstrated a dose‐response relationship between EPO and RBC expansion 27 . A study of “very low” dose EPO therapy in autologous blood donors found that 400 U/kg administered over a 2‐week interval resulted in clinically significant erythropoiesis 28 . As shown in Table 2, 24,27,29‐31 patients treated with ESA therapy during aggressive autologous blood phlebotomy had 358 to 1102 mL (28%‐48% RBC) expansion over 25 to 35 days, or the equivalent of 2 to 5 blood units.…”

Section: Functional Iron Deficiencymentioning

confidence: 99%

Iron deficiency syndromes and iron‐restricted erythropoiesis (CME)

Goodnough

2011

Transfusion

102

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The relationships between erythropoietin (EPO), iron, and erythropoiesis and the presence of iron-restricted erythropoiesis have important implications in anemia management. Iron-restricted erythropoiesis occurs in the presence of one or more iron deficiency syndromes: absolute iron deficiency, functional iron deficiency, and/or iron sequestration. Absolute iron deficiency is a common nutritional deficiency in women's health, pediatrics, and the elderly and is therefore an important public health problem. Functional iron deficiency occurs in patients with significant EPO-mediated erythropoiesis or therapy with erythropoiesis-stimulating agents, even when storage iron is present. Iron sequestration mediated by hepcidin is an underappreciated but common cause of iron-restricted erythropoiesis in patients with chronic inflammatory disease. The challenge for treating and laboratory-based physicians is to understand the contributory role(s) of each of these syndromes, so that the potential value of emerging and innovative pharmacologic strategies can be considered as options in patient blood management.

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Section: Functional Iron Deficiencymentioning

confidence: 99%

Iron deficiency syndromes and iron‐restricted erythropoiesis (CME)

Goodnough

2011

Transfusion

102

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“…(2002) showed that patients who had predonated autologous blood had lower Hb levels on admission, and higher likelihood of having autologous transfusion. Use of recombinant erythropoietin and iron during PAD has been reported to increase red cell production (Mollmann et al ., 1995; Price et al ., 1996), the number of autologous units donated (Price et al ., 1996; Sans et al ., 1996), and to reduce patient exposure to allogeneic blood (Price et al ., 1996).…”

mentioning

confidence: 99%

Preoperative autologous blood donation for bone marrow harvests: Are we wasting donors' time and blood?

Mijović

Britten

Regan³

et al. 2005

Transfusion Medicine

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Predeposit autologous blood donation (PAD) is frequently offered to bone marrow donors, but its cost-effectiveness is dubious. We assessed the impact of PAD and bone marrow donation on transfusion requirements; and the use of donated blood units in a retrospective study of 61 bone marrow donors. The mean haemoglobin (Hb) concentration fell from 12.9 to 11.8 g dL(-1) in women who predonated one unit and from 13.2 to 10.9 g dL(-1) in those who predonated two units. In men who donated two units of blood, the Hb concentration decreased to 12.9 g dL(-1). Bone marrow harvest led to a further decline in Hb concentration by 2.3 g dL(-1) in women and by 2.4 g dL(-1) in men. The postharvest Hb fell to or= 9.0 g dL(-1); overtransfusion was even more apparent in men: 71% units were given with a Hb >or= 10.0 g dL(-1). PAD in bone marrow donors is associated with high wastage and increases the likelihood of requiring a transfusion. We recommend that PAD should not be routinely offered to bone marrow donors.

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“…[40][41][42][43][44] The use of autologous donation and erythropoietin in patients with inadequate estimated red cell reserve and life expectancy >10 years is a cost-effective strategy for blood conservation. [45][46][47][48][49] Autologous donation is more cost-effective than allogeneic transfusion ($856 and $892 vs. $1769 and $1352 per unit for THA and TKA, respectively). 49 Autologous donation is also beneficial in that the risk of deep vein thrombosis is reduced.…”

Section: Management Of Blood Loss and Transfusionmentioning

confidence: 99%

Issues in Geriatric Orthopedic Anesthesia

Kunze¹

2014

International Anesthesiology Clinics

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Effectiveness of very low doses of subcutaneous recombinant human erythropoietin in facilitating autologous blood donation before orthopedic surgery

Cited by 37 publications

References 24 publications

Iron deficiency syndromes and iron‐restricted erythropoiesis (CME)

Iron deficiency syndromes and iron‐restricted erythropoiesis (CME)

Preoperative autologous blood donation for bone marrow harvests: Are we wasting donors' time and blood?

Issues in Geriatric Orthopedic Anesthesia

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