A Study on a New Method for Autologous Blood Transfusion Using Recombinant Human Erythropoietin

为了避免异体输血的副作用，我们对骨科手术患者进行了预存自体血回输，并使用或不使用重组人促红细胞生成素（rHu-EPO）。未给予rHu-EPO的患者在手术前每周献血400 ml，持续3周，总计1，200 ml，除非血红蛋白（Hb）值低于11.0 g/dl（对照组）。在相同的方案中，患者在手术前每周给予rHu-EPO（中外制药，东京）两次或三次，持续4周，还捐献了1200 ml自体血（EPO 2/W和EPO 3/W组）。对照组12例患者中有10例成功献血1200 ml，但献血前Hb值为13.8 g/dl，献血1200 ml后降至10.9 g/dl。EPO组的所有患者捐献了1，200 ml血液，EPO 2/W和3/W组的Hb值在献血前分别为13.0 g/dl和12.7 g/dl，仅在献血后分别轻微降至12.0 g/dl和12.0 g/dl。对照组Hb值下降2.9 g/dl，显著大于EPO组（EPO 2/W组为1.0 g/dl，EPO 3/W组为0.7 g/dl）。对照组的Hb值术后最低值为8.0 g/dl，对照组中有3例患者需要异体输血。EPO 2/W和3/W组的Hb值最低值分别为9.2和10.0 g/dl，均不需要输异体血。rHu-EPO可有效预防供者/受者因献血引起的贫血，避免异体输血。

To avoid the side effects by homologous blood transfusion, we conducted predeposit autologous blood transfusion in patients undergoing orthopedic surgery with or without use of recombinant human erythropoietin (rHu-EPO). The patients not given rHu-EPO donated 400 ml of blood weekly for 3 weeks, a total of 1, 200 ml, before operation, unless the hemoglobin (Hb) value was less than 11.0 g/dl (the control group). In the same protocol, the patients given rHu-EPO (Chugai Pharmaceutical, Tokyo) twice or thrice a week for 4 weeks before operation also donated 1, 200 ml of autologous blood (the EPO 2/W and EPO 3/W groups). Ten of 12 patients in the control group succeeded in donating 1, 200 ml of blood, but the Hb value of 13.8 g/dl at predonation dropped to 10.9 g/dl after 1, 200 ml donation. All patients in the EPO group donated 1, 200 ml of blood and the Hb values of 13.0 g/dl and 12.7 g/dl in the EPO 2/W and 3/W groups at predonation only slightly decreased to 12.0 g/dl and 12.0 g/dl after donation, respectively. The decreased Hb value of 2.9 g/dl in the control group was significantly greater than those of the EPO group (1.0 g/dl in the EPO 2/W and 0.7 g/dl in the EPO 3/W group). The postoperative nadir of the Hb value in the control group was 8.0 g/dl and three patients in the control required homologous transfusion. The nadir of the Hb values in the EPO 2/W and 3/W group was 9.2 and 10.0 g/dl, respectively and none required homologous blood transfusion. rHu-EPO was efficacious in preventing the donor/patients from anemia induced by donations and useful in avoiding homologous blood transfusion.