Use of recombinant human erythropoietin in orthopedic surgery

Jose Aguado Romeo M, Villegas Portero R
Record ID 32007000457
Authors' objectives: Main: To assess the efficacy of rHuEPO administered alone or with autologous blood in patients with normal levels of haemoglobin undergoing elective orthopaedic surgery, in terms of reducing the need for allogeneic (homologous) blood. Secondary: To attempt to determine the most appropriate dose of rHuEPO and the most effective time of administration, to assess the safety and efficacy of rHuEPO with regard to other clinical variables of the patient, the gender or type of surgery involved.
Authors' recommendations: Conclusions: There is no evidence of sufficiently good quality to support the indiscriminate use of rHuEPO in elective orthopaedic surgery in non-anaemic patients. rHuEPO administered under an autologous donation programme does not offer benefits that can be quantified in terms of units of autologus blood collected from non-anaemic patients, but it reduces the need for allogeneic blood transfusion. The administration of rHuEPO alone does not reduce the need for allogeneic blood transfusion. There is not a consensus on the necessary dose of rHuEPO to reduce allogeneic blood transfusion needs in this type of surgery. Iron supplements are needed to ensure appropriate rHuEPO performance, but there is no agreement on the minimum dose required, nor its mode of delivery. The lack of serious adverse effects means that rHuEPO treatment can be deemed safe for the patient. Care policy algorithms must be developed in order to ensure efficient use of this product. Recommendations: There is a need for higher-quality randomised, blinded studies to enable an assessment of the effects of rHuEPO in non-anaemic patients during surgery; assessments of cost-effectiveness in our setting, to support more efficient use of this product; and studies of alternative pharmacological products.
Authors' methods: Review
Project Status: Completed
Year Published: 2007
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Blood Transfusion, Autologous
  • Erythropoietin
  • Orthopedic Procedures
Organisation Name: Andalusian Health Technology Assessment Area
Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. InnovaciĆ³n, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309
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Copyright: Andalusian Agency for Health Technology Assessment (AETSA)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.