Mercuriali F
Centro di Immunoematologia e Trasfusionale, Istituto Ortopedico Gaetano Pini, Milan, Italy.
Semin Hematol. 1996 Apr;33(2 Suppl 2):10-2; discussion 13-4.
In patients scheduled to undergo major orthopedic surgery, predonation of autologous blood (AB) has emerged as a means of avoiding subsequent exposure to allogeneic blood. However, patients with a baseline hematocrit (Hct) less than 40% may not be able to donate sufficient AB to fully meet their requirements. In female patients with a baseline Hct < or = 39%, epoetin alfa (300 to 600 IU/kg twice weekly for 3 weeks) significantly increased the amount of AB donated prior to elective orthopedic surgery and significantly reduced allogeneic blood requirements in comparison with placebo. Iron availability was a critical factor in determining the response to epoetin alfa. In these patients, parenteral supplementation with iron saccharate significantly increased the amount of AB donated and the volume of red blood cells (RBCs) collected in comparison with oral iron alone. Parenteral iron supplementation, therefore, ensures that sufficient iron is available to meet the demands of epoetin alfa-accelerated erythropoiesis in patients enrolled in an AB donation program.
在计划接受大型骨科手术的患者中，自体血预存（AB）已成为一种避免随后接触异体血的方法。然而，基线血细胞比容（Hct）低于40%的患者可能无法捐献足够的自体血来完全满足其需求。在基线Hct≤39%的女性患者中，与安慰剂相比，促红细胞生成素α（每周两次，每次300至600 IU/kg，共3周）显著增加了择期骨科手术前捐献的自体血量，并显著降低了异体血需求量。铁的可利用性是决定对促红细胞生成素α反应的关键因素。在这些患者中，与单独口服铁剂相比，胃肠外补充蔗糖铁显著增加了自体血捐献量和采集的红细胞（RBC）量。因此，胃肠外补铁可确保有足够的铁来满足参与自体血捐献计划患者中促红细胞生成素α加速红细胞生成的需求。
