Preoperative autologous donation of 6 units of blood during rh-EPO treatment

Milbrink, Jan; Birgegård, Gunnar; Danersund, Antero; Helmers, C; Nordström, Lars; Sandhagen, Bo

doi:10.1007/bf03012783

Cited by 9 publications

(7 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, interest has recently focused on the pre-operative use of this agent to increase the RBC count and thereby to reduce the need for allogeneic RBC transfusions during elective surgery. The beneficial effect of epoetin among patients participating in PABD programmes has been previously reported [6,19], and several reports have documented its use for the pre-operative preparation of patients refusing RBC transfusions [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Low-Dose Epoetin Beta for the Avoidance of Transfusion in Patients Scheduled for Elective Surgery Not Eligible for Autologous Blood Donation

et al. 2001

View full text Add to dashboard Cite

This randomized, multicentre, parallel-group study assessed the efficacy of epoetin beta in reducing the transfusion frequency in patients ineligible for autologous blood donation prior to surgery. The patients (n = 194) received either epoetin beta (125 or 250 IU/kg, once weekly) or no therapy for 3–4 weeks before surgery. The pre-operation haemoglobin levels were markedly increased in the epoetin beta groups (125 IU/kg: +1.1 g/dl; 250 IU/kg: +1.6 g/dl), but not in the control group. The transfusion frequency was significantly reduced in both epoetin groups as compared with the control group (p = 0.046). Epoetin beta was well tolerated, and no serious adverse events were observed. Low-dose administration of epoetin beta before elective surgery reduces the transfusion frequencies in patients not eligible for autologous blood donation.

show abstract

Section: Discussionmentioning

confidence: 99%

Subcutaneous Low-Dose Epoetin Beta for the Avoidance of Transfusion in Patients Scheduled for Elective Surgery Not Eligible for Autologous Blood Donation

et al. 2001

View full text Add to dashboard Cite

show abstract

“…[5][6][7] Initially used in hemodialysis patients, the restoration of a normal hemoglobin level was shown to decrease anemia-related complications such as left ventricular hypertrophy and congestive heart failure as well as to attenuate the uremia-related bleeding diathesis seen in chronic renal failure patients. 8,9 The preoperative use of recombinant human erythropoietin is a more recent strategy, having received HPB approval for this use in Canada in 1996.…”

Section: Discussionmentioning

confidence: 99%

“…Healthy patients can expect a rapid return to baseline hemoglobin levels after the donation autologous blood for retransfusion during elective surgery. 7,10 Anemic patients treated with erythropoietin can expect a return to normal hemoglobin levels. 1 1 The adverse effects of recombinant human erythropoietin may include a rise in blood pressure and thrombosis of permanently installed venous access devices.…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation in a Jehovah’s Witness with ankylosing spondylitis

Baldry

Backman

Metrakos

et al. 2000

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: Orthotopic liver transplantation is typically associated with large volume blood loss. Technological and pharmacological advances permit liver transplantation in patients who formerly were not candidates for this surgery because of strict limitations on blood product administration. We describe a liver transplant in a Jehovah's Witness with ankylosing spondylitis.Clinical features: A 49-yr-old Jehovah's Witness with ankylosing spondylitis and end stage liver disease secondary to sclerosing cholangitis underwent orthotopic liver transplantation. Recombinant human erythropoietin (4,000 IU sc every two days for four weeks, then 4,000 IU sc every week) established a normal hemoglobin concentration preoperatively (>140 g·L -1 compared with 120 g·L -1 baseline). Intraoperatively, strategies for reducing risk of blood product transfusion included avoidance of hypothermia (T>35°C), minimal blood sampling (four 1 ml samples), normovolemic hemodilution (two units), administration of Aprotinin (2 million units bolus dose followed by infusion of 500,000 u·hr -1 ), and return of blood (1,500 ml) scavenged from the operative field. Estimated blood loss was 2,200 ml. The preoperative and postoperative hemoglobin concentration was 147 g·L -1 (hematocrit 0.45) and 123 g·L -1 (hematocrit 0.37), respectively. No blood products were required and he was discharged three weeks postoperatively without complication.Conclusion: Technological and pharmacological advances allow patients to undergo surgery traditionally associated with large volume blood loss with reduced risk of blood product administration.Objectif : La transplantation du foie orthotopique est typiquement associée à une perte de sang importante. Les progrès technologiques et pharmacologiques permettent de réaliser une transplantation hépatique chez des patients qui n'auraient pu subir cette opération auparavant à cause de limitations rigoureuses d'administration des produits sanguins. Nous décrivons une greffe hépatique chez un témoin de Jéhovah qui présente une spondylarthrite ankylosante.Éléments cliniques : Un témoin de Jéhovah de 49 ans souffrant de spondylarthrite ankylosante et d'une maladie hépatique terminale secondaire à une cholangite sclérosante a subi une greffe hépatique. L'administration d'érythropoïétine recombinante humaine (4 000 UI sc aux deux jours pendant quatre semaines, puis 4 000 UI sc chaque semaine) a établi une concentration d'hémoglobine préopératoire normale (>140 g·L -1 comparée à 120 g·L -1 au départ). Les stratégies peropératoires adoptées pour réduire le risque lié à la transfusion de produit sanguin comprenaient l'absence d'hypothermie (T >35 o C), le prélèvement minimal de sang (quatre échantillons de 1 ml), l'hémodilution normovolémique (deux unités), l'administration d'aprotinine (des bolus de deux millions d'unités suivis de perfusion de 500 000 u·h -1 ) et le retour du sang épuré (1 500 ml) provenant du champ opéra-toire. La perte sanguine a été de 2 200 ml. La concentration préopératoire et postopératoire d'hémoglobine a ét...

show abstract

“…Where oral iron is not tolerated, parenteral iron, preferably iron sucrose 18 may be effective in raising the preoperative haemoglobin. In patients with significant iron deficiency, however, most workers use a combination of iron and preoperative erythropoietin (EPO) to ensure the expected rise of haemoglobin by 1g per week 14,[24][25][26][27][28] . The doses of EPO used range between 150-600iu/kg/week 9,[18][19][20][21][22][23][24][25][26][27][28] .…”

Section: Haematinics and Erythropoietinmentioning

confidence: 99%

Blood Conservation in Anaesthesia and Surgery - A Review

Aniteye¹,

Baddoo²,

Phillips³

et al. 2022

gcps

View full text Add to dashboard Cite

Dangers to blood transfusion exist even when stringent methods are used to screen blood before transfusion. These dangers include blood transfusion reactions and the transmission of bacteria, viruses and protozoa to patients. Blood conservation adopts strategies that restrict the transfusion of homologous blood to patients. Conservation starts in the preoperative period and includes the diagnosis and management of anaemia. Augmentation of the preoperative haemoglobin can be achieved by using a combination of iron preparations, vitamins, protein supplementation, erythropoietin and treatment for malaria in suspected patients. Maintenance of the intravascular volume during surgery can be achieved using colloids and crystalloids. Blood conservation techniques, including induced hypotension, use of anti-fibrinolytics and acceptable forms of autologous blood transfusion reduce the need for allogeneic blood transfusion. Blood conservation methods are also important in critically ill patients and includes, accepting lower haemoglobin levels, restricting the amount of blood taken during phlebotomy and the use of erythropoietin/erythropoietin receptor agonists.

show abstract

Preoperative autologous donation of 6 units of blood during rh-EPO treatment

Cited by 9 publications

References 11 publications

Subcutaneous Low-Dose Epoetin Beta for the Avoidance of Transfusion in Patients Scheduled for Elective Surgery Not Eligible for Autologous Blood Donation

Subcutaneous Low-Dose Epoetin Beta for the Avoidance of Transfusion in Patients Scheduled for Elective Surgery Not Eligible for Autologous Blood Donation

Liver transplantation in a Jehovah’s Witness with ankylosing spondylitis

Blood Conservation in Anaesthesia and Surgery - A Review

Contact Info

Product

Resources

About