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Experimental and Clinical Results of Perioperative Treatment with Recombinant Human Erythropoietin

  • O. R. C. Busch
  • M. A. W. Hoynck van Papendrecht
  • R. L. Marquet
  • J. Jeekel

Abstract

The side effects of allogeneic blood transfusions are nowadays well known [1]. Especially the risk of transmitting viral infections is a reason to seek methods to reduce the need for allogeneic blood transfusions. Many retrospective studies suggest that in patients undergoing resection for malignancy there is a further adverse effect of blood transfusions: perioperative transfusions may stimulate tumor growth and therefore worsen the prognosis of these patients [2, 3]. Additionally, the rate of postoperative infectious complications may be increased if blood transfusions are given [4]. All these effects can be avoided if the patient’s own blood is used because this is the safest blood to be transfused. Autologous transfusions can be achieved in several ways: (a) by predeposit autologous blood donations, (b) by preoperative intentional hemodilution, and (c) by reinfusion of blood saved during the operation. In cancer surgery these methods may have their limitations due to logistical problems and anemia. In addition, intraoperative cell saving is not allowed in cancer surgery because of the possibility of introducing metastases.

Keywords

Blood Transfusion Recombinant Human Erythropoietin Allogeneic Blood Transfusion Postoperative Infectious Complication Autologous Blood Donation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Walker RH (1987) Transfusion risks. Am J Clin Pathol 88: 374–378PubMedGoogle Scholar
  2. 2.
    Marquet RL, de Bruin RWF, Dallinga RJ, Kumar S, Jeekel J (1986) Modulation of tumor growth by allogeneic blood transfusion. J Cancer Res Clin Oncol 111: 50–53PubMedCrossRefGoogle Scholar
  3. 3.
    Blumberg N, Heal JM (1989) Transfusion and host defences against cancer recurrence and infection. Transfusion 29: 236–245PubMedCrossRefGoogle Scholar
  4. 4.
    Tartter PI (1988) Blood transfusion and infectious complications following colorectal cancer surgery. Br J Surg 75: 789–792PubMedCrossRefGoogle Scholar
  5. 5.
    Winearls CG, Oliver DO, Pippard MJ, Reid C, Downing MR, Cotes PM (1986) Effect of human erythropoietin derived from recombinant DNA on the anemia of patients maintained by chronic haemodialysis. Lancet 2: 1175–1178PubMedCrossRefGoogle Scholar
  6. 6.
    Hoynck van Papendrecht MAW, Jeekel J, Marquet RL. Dosage of recombinant human erythropoietin in autologous blood donation programs; a study in rats (submitted)Google Scholar
  7. 7.
    Levine EA, Rosen AL, Gould SA et al. (1988) Recombinant human erythropoietin and autologous blood donation. Surgery 104: 365–369PubMedGoogle Scholar
  8. 8.
    Goodnough LT, Rudnick S, Price TH et al. (1989) Increased preoperative collection of autologous blood with recombinant human erythropoietin therapy. N Engl J Med 321: 1163–1168PubMedCrossRefGoogle Scholar
  9. 9.
    Levine EA, Gould SA, Rosen AL et al. (1989) Perioperative recombinant human erythropoietin. Surgery 106: 423–428Google Scholar
  10. 10.
    Krieter H, Brückner UB, Krumwieh D, Seiler FR, Messmer K (1990) Erythropoietin accelerates the recovery from extreme hemodilution: a randomized, placebo-controlled study in dogs. Eur Surg Res 22: 121–127PubMedCrossRefGoogle Scholar
  11. 11.
    Muirhead N, Hodsman AB (1990) Occult infection and resistance of anaemia to rHuEPO therapy in renal failure. Nephrol Dial Transplant 5: 232–234PubMedGoogle Scholar
  12. 12.
    Hoynck van Papendrecht MAW, Jeekel J, Busch ORC, Marquet RL. The efficacy of recombinant erythropoietin to obviate the need for blood transfusions in surgery (in preparation)Google Scholar
  13. 13.
    Adamson JW, Eschbach JW (1990) The use of recombinant human erythropoietin (rHuEPO) in humans. Cancer Surv 9: 157–167PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • O. R. C. Busch
  • M. A. W. Hoynck van Papendrecht
  • R. L. Marquet
  • J. Jeekel

There are no affiliations available

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