The Effect of Recombinant Human Erythropoietin on Pre and Postoperative Anemia in Patients Undergoing General Surgery -Multicentral Trial-

Keisuke Yoshida, Terukazu Muto¹⁾, Shozo Mori, Tetsuro Nishihira²⁾, Katsuji Okui, Tsuguhiro Tashiro³⁾, Yasuhiko Morioka, Tetsuichiro Muto, Kimitaka Suzuki⁴⁾, Osahiko Abe, Masakazu Ueda⁵⁾, Masahiko Tsurumaru, Harushi Udagawa⁶⁾, Takesada Mori, Junichi Kanbayashi⁷⁾, Keizo Sugimachi, Makoto Hashizume⁸⁾, Hisaaki Shimazu, Sonshin Takao⁹⁾

¹⁾The First Department of Surgery, Niigata University school of Medicine
²⁾The Second Department of Surgery, Tohoku University School of Medicine
³⁾The First Department of Surgery, School of Medicine, University of chiba
⁴⁾The First Department of Surgery, Faculty of Medicine, The University of Tokyo
⁵⁾The Department of Surgery, School of Medicine, Keio University
⁶⁾The Department of Surgery, Toranomon Hospital
⁷⁾The Second Department of Surgery, Osaka University Medical School
⁸⁾The Second Department of Surgery, Faculty of Medicine, Kyushu University
⁹⁾The First Department of Surgery, Faculty of Medicine, Kagoshima University

The usefulness of recombinant human erythropoietin (r-HuEPO) to eliminate the need for perioperative blood transfusion was investigated in patients who mostly underwent digestive tract surgery. A dose of 200 IU of r-HuEPO per kg was given concomitantly with iron (40 mg) for 7 days before and for 14 days after surgery. Hemoglobin, hematocrit and red blood cell levels significantly increased following preoperative administration of r-HuEPO for 7 days. However, the increase in hemoglobin was only 0.3 g/dl on average. Therefore, further studies appear necessary to find a more effective method of administration, i.e. a more appropriate dosage and administration period. Postoperative anemia was improved from the 4th postoperative day (POD), a significantly better result than that seen in controls whose hematocrit continued to decrease up to the 10th POD. As side effects, a flu-like syndrome, hepatic function disorder, fever and rash were seen in one patient each. Two patients had abnormal laboratory findings. Of these, one showed a rise in GOT, GPT and Al-p and the other showed a rise in LDH. These side effects and abnormal laboratory findings were, however, not severe. Fever and the rise in LDH were judged to be related to r-HuEPO therapy. These results suggest that perioperative administration of r-HuEPO is safe and useful for eliminate, or reduce the volume of blood transfusion in general surgery.

Key words
anemia, postoperative anemia, erythropoietin

Reprint requests
Keisuke Yoshida The First Department of Surgery, Niigata University School of Medicine
Asahimachi-dori, Niigata, City 951 JAPAN

Accepted
October 9, 1991

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