Preoperative Recombinant Human Erythropoietin Injection Versus Preoperative Autologous Blood Donation in Patients Undergoing Radical Retropubic Prostatectomy

Chun, Thomas Y.; Martin, Sean; Lepor, H.

doi:10.1016/s0022-5347(01)63628-0

Cited by 7 publications

(10 citation statements)

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“…[51] This increase in the hematocrit is greater than the erythropoietic response to the iatrogenic anemia resulting from preoperative autologous blood donation. [50] We have reported that the transient increase in the hematocrit is not associated with any increased risk of thromboembolic complications. [52] In my last 400 radical prostatectomies, the allogeneic blood transfusion rate was less than 4%.…”

Section: Decreasing Requirement For Blood Transfusionmentioning

confidence: 92%

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Radical Prostatectomy: Status and Opportunities for Improving Outcomes

Lepor¹

2004

Cancer Investigation

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Section: Decreasing Requirement For Blood Transfusionmentioning

confidence: 92%

“…[50] Specifically, 300 IU/kg are currently administered 14 and seven days prior to surgery. [51] The mean increase in hematocrit elicited by the two injections of recombinant erythropoietin is approximately four percentage points, which is equivalent to over one unit of packed red blood cells.…”

Section: Decreasing Requirement For Blood Transfusionmentioning

confidence: 99%

Radical Prostatectomy: Status and Opportunities for Improving Outcomes

Lepor¹

2004

Cancer Investigation

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“…In one study, patients in The Netherlands with preoperative hemoglobin levels between 10 and 13 g/dl received an increased dosage, 600 IU/kg of EPO once a week starting 3 weeks before the scheduled surgery [65]. A high dose of 40,000 IU, given three times preoperatively, has been shown to be extremely efficient but costs about $3,000 [13]. Relative contraindications to EPO administration include personal and familial history of thromboembolic events, severe hypertension, allergy, pregnancy, or breastfeeding.…”

Section: Autologous Blood Donationmentioning

confidence: 99%

Alternative Procedures for Reducing Allogeneic Blood Transfusion in Elective Orthopedic Surgery

et al. 2010

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Perioperative blood loss is a major problem in elective orthopedic surgery. Allogeneic transfusion is the standard treatment for perioperative blood loss resulting in low postoperative hemoglobin, but it has a number of well-recognized risks, complications, and costs. Alternatives to allogeneic blood transfusion include preoperative autologous donation and intraoperative salvage with postoperative autotransfusion. Orthopedic surgeons are often unaware of the different pre- and intraoperative possibilities of reducing blood loss and leave the management of coagulation and use of blood products completely to the anesthesiologists. The goal of this review is to compare alternatives to allogeneic blood transfusion from an orthopedic and anesthesia point of view focusing on estimated costs and acceptance by both parties.

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“…Liberale Verabreichung von allogenen Transfusionen führt zu deutlicher Erhöhung postoperativer bakterieller Infektionen. 20 Pilotstudie mit prospektiv randomisiertem Design zur Auswirkung von Fremdbluttransfusionen auf postoperative Mortalität nach Hüftoperationen. Kein Unterschied durch höhere Transfusionsraten.…”

Section: Allogene Transfusionunclassified

“…Die alleinige Verabreichung von Erythropoietin hat sich im Hinblick auf den Fremdblutverbrauch bei urologischen und orthopädischen Patienten mit niedrigen Hämoglobinausgangswerten der Eigenblutspende als ebenbürtig erwiesen, stellt aber perioperativ höhere Hä-moglobinwerte sicher [20,28,87]. Dies ist besonders bei jenen Patienten wichtig, die aufgrund kardiovaskulärer Erkrankungen einen zu starker Abfall des Hämatokrits schlecht tolerieren [18, 29, 32 23 , 51, 52].…”

Section: Erythropoietin Dieunclassified

Perioperative Anämie

Kulier¹,

Gombotz²

2001

Anaesthesist

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Anemia is a frequent finding, particularly in the elderly population, and usually indicative of a serious disease. The main causes of preoperative anemia are acute or chronic hemorrhage, iron deficiency, renal insufficiency, inflammatory and neoplastic diseases. A preexisting mild anemia may be enhanced or unmasked by surgically induced bleeding or repeated diagnostic phlebotomies, and by a postoperative erythropoietic dysfunction caused by the surgical trauma, irrespective of any hemorrhage. Low hemoglobin values are associated with a distinct increase of mortality and morbidity, both in the normal population and perioperatively and in the critically ill patients. The anemia-associated risk is exacerbated by preexisting cardiovascular disease, important intraoperative blood loss and advanced age. In contradiction to established therapeutical concepts, the administration of allogeneic blood beyond hemoglobin levels of 8-10 g/dl has not been found to decrease perioperative or intensive care morbidity or mortality. Rather, in addition to the inherent long-term risks of transfusions, a liberal transfusion strategy seems to increase the incidence of postoperative complications. Thus, current transfusion guidelines tend to be interpreted in an increasingly restrictive manner. Depending on the urgency of the clinical situation, the primary goal should be to diagnose and treat the underlying disease, rather than to focus on the symptom anemia. Time permitting, the patient's cardiovascular and pulmonary status should be optimized preoperatively. Furthermore, iron should be substituted to treat and prevent deficiency. Recombinant human erythropoietin has successfully been used to treat anemia of chronic renal failure and chronic disease, as well as in the perioperative and intensive care setting, and to support the efficiency of autologous programs.

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Preoperative Recombinant Human Erythropoietin Injection Versus Preoperative Autologous Blood Donation in Patients Undergoing Radical Retropubic Prostatectomy

Cited by 7 publications

References 0 publications

Radical Prostatectomy: Status and Opportunities for Improving Outcomes

Radical Prostatectomy: Status and Opportunities for Improving Outcomes

Alternative Procedures for Reducing Allogeneic Blood Transfusion in Elective Orthopedic Surgery

Perioperative Anämie

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