Document Detail

Erythropoiesis, erythropoietin, and iron metabolism in elective surgery: preoperative strategies for avoiding allogeneic blood exposure.
MedLine Citation:
PMID:  8546246     Owner:  NLM     Status:  MEDLINE    
Preoperative autologous donation (PAD) of blood and administration of recombinant human erythropoietin (Epoetin alfa) are two strategies for increasing red blood cell (RBC) mass preoperatively. The success of PAD depends primarily on the patient's ability to manufacture new RBCs before surgery to replace those removed during PAD. Red blood cell manufacture depends in turn on adequate supplies of iron and the increased renal production of endogenous erythropoietin following PAD. Successful PAD also requires adequate time for regeneration of predonated RBCs. Parenteral administration of Epoetin alfa causes a dose-dependent stimulation of RBC production. Its use has been studied as an adjunct to PAD and as a method to enhance endogenous erythropoiesis without PAD. Several studies suggest that administration of Epoetin alfa, begun several days before surgery, may stimulate erythropoiesis and help decrease the number of RBC transfusions required postoperatively. The precise role of Epoetin alfa in the surgical setting is not yet established, and optimal dosage regimens have not been determined.
M A Goldberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  170     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-02-13     Completed Date:  1996-02-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  37S-43S     Citation Subset:  AIM; IM    
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
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MeSH Terms
Anemia / prevention & control*
Blood Transfusion, Autologous*
Drug Administration Schedule
Erythrocyte Transfusion
Erythropoiesis / drug effects*,  physiology
Erythropoietin / administration & dosage*,  pharmacokinetics
Ferritins / blood
Inflammation / physiopathology
Osteoarthritis / surgery
Postoperative Complications / prevention & control*
Preoperative Care
Recombinant Proteins / administration & dosage,  pharmacokinetics
Surgical Procedures, Elective*
Reg. No./Substance:
0/Recombinant Proteins; 11096-26-7/Erythropoietin; 9007-73-2/Ferritins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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