Transfusion and haemostasis
Background and Goal of study: The aim of this study was to investigate the effect of recombinant human erythropoietin (r-HuEPO) administration on perioperative haemoglobin concentrations and on the number of blood transfusions in patients undergoing radical prostatectomy.
Materials and Methods: In this double-blind placebo - controlled study 30 patients received subcutaneous r-HuEPO in a dose of 600IU/kg body weight plus iron supplementation with 300 mg ferrous sulphate orally beginning on preoperative day 10 and 30 patients received placebo medication iron (control group). The patients received erythropoietin on preoperative day 10,7 and 4 provided their baseline haemoglobin value level 8,5-13gr/dl. Intraoperative blood loss was estimated by the amount of blood collected in the aspirator and by the weight of the gauzes used. The indication of blood transfusion was haemoglobin value of 8,5gr/dl or less. In all patients blood cell counts and serum chemistries were performed every second day until discharge. In addition reticulocytes ferritin and iron were measured at admission, the day of operation and at discharge. For statistical analysis the student t test was used to compare means of measures. The paired sampled t test was used to compare values of hematocrit, haemoglobin, and reticulocytes, in all the patients. Statistical significance was achieved at p < 0,05.
Results and Discussion: Patients who received erythropoietin received significantly fewer transfusion intraoperative and postoperatively (10 patients with a total of 20 units vs 21 patients with a total of 48 units) p < 0,05. In addition during the postoperative period a markedly increased number of patients (n = 10) from the control group received an allogenic transfusion compared to two patients in the study group who were transfused. p < 0,05. Postoperatively the study group had significantly higher haematocrit, haemoglobin and reticulocytes count values compared to the control group.
Conclusion: Patients who underwent radical prostatectomy benefit from perioperative erythropoietin administration in terms of stimulated erythropoiesis and reduction of blood transfusions.
1 Nieder A, Rosenblum N, Lepor H. Urology 2001; 57: 737-741.