Abstract
In an attempt to eliminate the hazards of homologous blood transfusions during major orthopedic surgery, 19 female patients donated 1, 200ml of autologous blood before operation.
400ml blood was donated once a week for three weeks before operation and kept in a refrigerator at 4°C. Patients were divided into 3 groups: Group A (5 patients) received 6, 000 units of r-HuEPO three times a week. Group B (6 patients) received 6, 000 units of r-HuEPO twice a week. Group C (8 patients) were controls and did not receive r-HuEPO. All the patients were given ferrous sulfate, 210mg of iron, orally every day from 2 or 3 weeks before the first donation.
All the patients were able to collect 1, 200ml of autologous blood. After donation of 1, 200ml blood, hemoglobin levels of each group became 93.5±5.1% (12.7±0.5g/dl), 91.5±1.6% (11.8±0.3g/dl) and 77.6±3.4% (10.7±0.6g/dl) of those at the predonation. Group A and Group B remained almost within normal hemoglobin level. These levels were significantly higher in Group A and Group B than in Group C. The lowest hemoglobin levels after operation of each group were 74.5±8.6% (10.1±1.0g/dl), 71.8±9.3% (9.0±1.0g/dl) and 58.6±7.6% (8.0±0.9g/dl) of those at the predonation. Both Group A and Group B used autologous blood only, while 2 of 8 patients in Group C received 2 or 3 units of homologous blood. During donation any side effects or complications did not occur and after donation none of the transfusion transmitted diseases were recognized.
Predeposited autologous blood transfusion is a simple, safe, and cost-effective method to prevent transfusion related reactions and infections, but 1, 200ml blood donation in 21 days without using r-HuEPO sometimes leads the patients anemic and requires additional homologous blood. In this study, 1, 200ml of autologous blood donation was performed safely and easily using r-HuEPO, so it can be possible to perform most of the elective surgery using predonated autologous blood.
