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January 1, 1999Orthopedics

An Open-Label, Randomized Study to Compare the Safety and Efficacy of Perioperative Epoetin alfa With Preoperative Autologous Blood Donation in Total Joint Arthroplasty

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Why the study?

Does Epoetin alfa improve hemoglobin levels and reduce allogeneic blood transfusions compared to preoperative autologous donation in patients undergoing total joint arthroplasty?

Population

490 patients scheduled for total joint (hip or knee) surgery with hemoglobin levels ≥ 11 to ≤ 13 g/dL

Comparison

Subcutaneous Epoetin alfa weekly on preoperative… vs Preoperative autologous donation (PAD) program

Design

RCT, randomized, parallel-group, open-label

Follow-up

until discharge

Authors

CSChristopher P. StowellBoston UniversityHCHugh P. ChandlerBrigham and Women's HospitalMJMaurice JovéMemorial Hermann

Discussion

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Overview

Epoetin alfa achieves higher perioperative Hb than PAD in TJA; extends RCT evidence favoring erythropoietin over autologous donation.

Structured PICO

Does Epoetin alfa improve hemoglobin levels and reduce allogeneic blood transfusions compared to preoperative autologous donation in patients undergoing total joint arthroplasty?

P
Population
490 patients scheduled for total joint (hip or knee) surgery with hemoglobin levels ≥ 11 to ≤ 13 g/dL
I
Intervention
Subcutaneous Epoetin alfa weekly on preoperative Days -21, -14, and -7, and on the day of surgery
C
Comparator
Preoperative autologous donation (PAD) program
O
Outcome
Safety and efficacy (allogeneic blood transfusion rates and hemoglobin levels)surrogate

Perioperative Epoetin alfa significantly improves hemoglobin levels and reduces total blood units transfused compared to preoperative autologous donation in total joint arthroplasty.

Cite This Study

Stowell et al. (1999) studied this question.

synapsesocial.com/papers/6a84fb718beb37cebc847592https://doi.org/10.3928/0147-7447-19990102-02
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Current Concepts Review - Blood Transfusion in Orthopaedic Operations*1996 · 105 citations
  2. 2Use of autologous blood in total hip replacement. A comprehensive program.1991 · 89 citations
  3. 3Hemolytic transfusion reaction following transfusion of frozen and washed autologous red cells1991 · 45 citations
  4. 4Red blood cell mass in autologous and homologous blood units1989 · 83 citations