Optimization of the Dosing Schedule of Recombinant Human Erythropoietin
for Perioperative Autologous Blood Donation in Patients undergoing Total
Aim: The purpose of this study was to optimize the dosing schedule of
recombinant human erythropoietin (rhEPO) for perioperative autologous
blood donation in patients undergoing total knee arthroplasty (TKA).
Method: TKA patients receiving different dosing schedules of rhEPO were
randomly divided into three groups. Group A patients were given 10,000
IU of subcutaneous rhEPO (1 ml) daily from preoperative day 5 to
postoperative day 3 (9 doses); Group B patients were given subcutaneous
normal saline daily from preoperative day 5 to day 3 and then
subcutaneous rhEPO daily until postoperative day 3 (6 doses in total);
Group C patients were given subcutaneous normal saline daily from
preoperative day 5 to the day before surgery and then subcutaneous rhEPO
daily from the surgery day to postoperative day 3 (4 doses). Results: A
total of 180 TKA patients were included. On postoperative day 1 and 3,
group A showed significantly higher Hb levels than group B and group C.
The calculated blood loss was significantly greater in groups B and C
than in group A on the day after surgery. Regarding total blood loss,
groups B and C lost significantly more blood than group A. No case of
allogeneic transfusion occurred during the trial in any of the three
groups. Conclusions: A small dose of daily rhEPO from preoperative day 5
to postoperative day 3 could significantly increase perioperative
autologous blood donation efficacy and slow the decline in postoperative
Hb levels in TKA patients without causing extra complications.