BLOOD DONATION FOR AUTOLOGOUS USE BY ORTHOPEDIC PATIENTS WITHOUT THE USE OF RECOMBINANT ERYTHROPOIETIN

We analyzed the use of recombinant erythropoietin (r-EPO) among 368 patients, each of whom had donated more than 800ml for later autologous transfusion during orthopedic surgery. Of the 269 patients who would have required r-EPO according to the health insurance authority guideline, 259 patients were able to donate blood without using r-EPO with no observed adverse effects, despite a significantly lower average Hb level (12.8±1.1g/dl) than the 99 patients who did not require r-EPO according to that guideline (14.8±0.7g/dl). The remaining 10 patients had Hb levels less than 11g/dL at the start of the blood donation and were given r-EPO. Analysis of the data of the two groups which did not use r-EPO revealed that there was no statistically significant difference in the mean total volume of donated blood nor in the frequency of required allogenic blood, but that the mean donation period was significantly longer in the 259 patients at 19.4±12.1 days vs 15.5±8.8 days. These findings therefore indicate that most orthopedic patients who need 800ml of blood during surgery can safely donate this amount of autologous blood without using r-EPO if they start donation 30 days or more prior to surgery.