BACKGROUND Recently, autologous blood transfusion has been widely endorsed, because of the adverse effects attributed to homologous blood transfusion. We found that the administration of recombinant human erythropoietin (rH-EPO) permitted the preoperative collection of an adequate volume of autologous blood in a short period of time. This reduced or eliminated the need for homologous blood transfusion. METHODS To determine optimal
dosage of rH-EPO, I conducted a randomized, controlled trial in 86 patients with benign prostatic hypertrophy (BPH) scheduled for transurethral resection of the prostate (TUR-P). The patients from whom approximately 10% of their total blood volume was removed, received six different doses of rH-EPO either intravenously or subctaneously. All patients received iron sulfate 100 mg orally once a day during the study. RESULTS I found that 9,000 IU of rH-EPO given intravenously daily or 10,500 IU of rH-EPO injected subcutaneously every third day for a week were optimal dosages. These schedules ennabled us to withdraw approximately 400 ml of blood prior to operation without adverse effects. CONCLUSION I conclude that the efficacy of rH-EPO is greater when administered subcutaneously rather than intravenously. It is clear that rH-EPO increases the ability of patients about to undergo selective surgery to donate greater amounts of blood for future autologous transfusion.