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

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.