Autologous blood donation with recombinant human erythropoietin in cardiac surgery: the Japanese experience.

Four units of predonated autologous blood (AB) is considered sufficient to cover the blood requirements of 95% of patients undergoing elective cardiac surgery, thus avoiding the risks associated with allogeneic blood transfusion. A review of six Japanese studies was undertaken to summarize the potential for recombinant human erythropoietin (rHuEPO) to facilitate donation of AB by patients scheduled for cardiac surgery. Intravenous (i.v.) administration of rHuEPO improved the anemia associated with AB donation, an effect that was further enhanced by i.v. iron supplementation. Once weekly subcutaneous (s.c.) administration of rHuEPO facilitated the donation of AB and reduced allogeneic blood requirements in patients scheduled for cardiac surgery, suggesting that rHuEPO could be administered on an outpatient basis. rHuEPO was of particular benefit in anemic patients, eliminating exposure to allogeneic blood in the majority of patients. In conclusion, rHuEPO facilitates the donation of AB and reduces allogeneic blood requirements of patients scheduled for cardiac surgery.