Abstract
Aim: The purpose of this study was to optimize the
dosing schedule of recombinant
human erythropoietin (rhEPO) for perioperative autologous blood donation
in patients undergoing total knee arthroplasty (TKA). Method:TKA patients receiving different dosing schedules of rhEPO were randomly
divided into three groups. Group A patients were given 10,000 IU of
subcutaneous rhEPO (1 ml) daily from preoperative day 5 to postoperative
day 3 (9 doses); Group B patients were given subcutaneous normal saline
daily from preoperative day 5 to day 3 and then subcutaneous rhEPO daily
until postoperative day 3 (6 doses in total); Group C patients were
given subcutaneous normal saline daily from preoperative day 5 to the
day before surgery and then subcutaneous rhEPO daily from the surgery
day to postoperative day 3 (4 doses). Results: A total of 180
TKA patients were included. On postoperative day 1 and 3, group A showed
significantly higher Hb levels than group B and group C. The calculated
blood loss was significantly greater in groups B and C than in group A
on the day after surgery. Regarding total blood loss, groups B and C
lost significantly more blood than group A. No case of allogeneic
transfusion occurred during the trial in any of the three groups.Conclusions: A small dose of daily rhEPO from preoperative day
5 to postoperative day 3 could significantly increase perioperative
autologous blood donation efficacy and slow the decline in postoperative
Hb levels in TKA patients without causing extra complications.
Key words: total knee
arthroplasty, recombinant human erythropoietin, autologous blood
donation, dosing schedule