Abstract
Preoperative anemia in a surgical patient predisposes to poor outcomes and allogeneic blood transfusions. As an alternative to transfusions, pharmacologic management of preoperative anemia with recombinant human erythropoietin (rHuEPO) has been well studied in many different types of surgery. rHuEPO, when used alone or in combination with preoperative autologous blood donation before elective surgery, stimulates erythropoiesis and helps to avoid or reduce the need for allogeneic blood transfusions. The clinical evidence on preoperative use of rHuEPO in orthopedic, cardiac, and cancer surgery, as well as in bloodless surgery, is reviewed.
Highlights
Anemia, which can be defined as hemoglobin less than 13 g/dl or hematocrit less than 36%, is a relatively common preoperative finding
A low initial hemoglobin level measured at disease presentation is a risk factor for further development of anemia throughout the course of treatment
It has been documented that patients prefer to receive autologous blood [8], those who are anemic before surgery are not candidates for preoperative autologous donation (PAD)
Summary
Benoist S, Panis Y, Pannegeon V, Alves A, Valleur P: Predictive factors for perioperative blood transfusions in rectal resection for cancer: a multivariate analysis of a group of 212 patients. GD: Allogeneic red blood cell transfusion is an independent risk factor for the development of postoperative bacterial infection. Amato AC, Pescatori M: Effect of perioperative blood transfusions on recurrence of colorectal cancer: meta-analysis stratified on risk factors.
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