Document Detail


Preoperative recombinant human erythropoietin injection versus preoperative autologous blood donation in patients undergoing radical retropubic prostatectomy.
MedLine Citation:
PMID:  9372883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: In an effort to avoid allogeneic transfusions, many patients scheduled for radical retropubic prostatectomy (RRP) participate in preoperative autologous donation (PAD) programs. Yet, PAD programs are costly, time-consuming, and not without risks. Perioperative administration of recombinant human erythropoietin (Epoetin alfa) also has been shown to reduce patients exposure to allogeneic transfusion. This study sought to compare the costs and transfusion rates associated with either PAD or perioperative Epoetin alfa in patients undergoing RRP. METHODS: The study population consisted of 120 men randomized to one of two treatment groups. Patients in group 1 donated up to 3 U of autologous blood preoperatively, provided that their hematocrit (HCT) was 33% or higher. Patients in group 2 received 600 IU/kg of Epoetin alfa on days -14 and -7 preoperatively, provided that their HCT was 46% or lower. RESULTS: Overall, 107 (89%) of 120 patients underwent RRP. In group 1, 5 (9.6%) of 52 patients received a total of 12 U of allogeneic blood (0.23 U/patient). In group 2, 5 (9.6%) of 52 patients received a total of 10 U of allogeneic blood (0.19 U/patient). Three patients in group 1 but no patients in group 2 experienced an adverse event. The average costs related to PAD and pharmacologic administration per patient were $540 in group 1 and $657 in group 2. Participation in PAD required an average of 5 hours more per patient compared with Epoetin alfa administration. CONCLUSIONS: Preoperative Epoetin alfa therapy is safe, well tolerated, and equally effective as PAD in reducing allogeneic blood transfusion requirements. Epoetin alfa therapy also is comparable in cost to PAD and offers patients greater convenience and less of a time commitment.
Authors:
T Y Chun; S Martin; H Lepor
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Urology     Volume:  50     ISSN:  0090-4295     ISO Abbreviation:  Urology     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1997-12-19     Completed Date:  1997-12-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  727-32     Citation Subset:  IM    
Affiliation:
Department of Urology, New York University Medical Center, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Loss, Surgical / prevention & control*
Blood Transfusion, Autologous* / economics
Costs and Cost Analysis
Erythropoietin, Recombinant / administration & dosage*,  economics
Hematocrit
Humans
Male
Middle Aged
Preoperative Care
Prostatectomy*
Chemical
Reg. No./Substance:
0/Erythropoietin, Recombinant

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


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