Autologous blood donation with erythropoietin in abdominal aortic aneurysm repair: Special reference to blood pressure and hormonal changes

Recombinant erythropoietin (rEPO) is used in autologous blood donation, but its usefulness and side effects have not been evaluated thoroughly. A prospective clinical study was conducted in 20 patients with abdominal aortic aneurysm who underwent surgery following autologous blood predonation with rEPO therapy. The patients were 19 men and one woman ranging in age from 59 to 79 years old. The blood pressure was measured before and after blood withdrawal and rEPO injection, and before and after rEPO injection alone. The levels of endogenous EPO, prolactin, growth hormone, and thyroid hormones were compared before the first blood withdrawal and just before surgery. The volume of blood withdrawn was 800 mL (400 mL at each of two withdrawals) within 2 weeks, while 6,000 units of rEPO were injected four times. The blood pressure dropped after blood withdrawal and rEPO injection, but it showed no marked change after rEPO injection alone. The mean value of hemoglobin was decreased from 13.8 to 12.4 g/dL in 2 weeks, and all patients received autologous blood transfusion during surgery. No declamping shock was noticed, and only 2 of the 20 patients needed homologous blood transfusion. The levels of growth hormone and thyroid hormones did not change, but that of prolactin increased following blood predonation with rEPO therapy. No significant change of endogenous EPO was observed.