Optimising collection of autologous blood: A pilot study of the use of recombinant human erythropoietin and parenteral iron

Objective: To optimise collection of sufficient autologous blood for elective surgery.Methods: Prospective study of 40 patients referred for donation of autologous blood, who were booked for elective orthopaedic surgery in the period August 1992 - September 1994. Patients received recombinant erythropoietin (r-EPO) to stimulate erythropoiesis, and sufficient iron by injection so that iron deficiency did not limit the bone marrow response to the r-EPO.Results: Thirty-eight of the 40 patients treated with this protocol stored an average of 3.7 units each on a twice-weekly donation schedule. Only one patient required supplemental homologous blood (two units) in subsequent surgery. One patient developed persistent hypotension, and one a late reaction to parenteral iron (which was controlled with corticosteroids). There were no other adverse events.Conclusions: r-EPO in combination with parenteral iron is a safe and effective method of ensuring the collection of optimal amounts of autologous blood before surgery

Screening for abdominal aortic aneurysm: does it affect men's quality of life?

A prospective study investigated the psychological wellbeing and quality of life of older rural men after a community-based screening for abdominal aortic aneurysm (AAA). Five hundred and sixteen men aged 65-74 years attended the screening program; 53 had an abnormal aorta detected. These and a subsample of men with a normal aorta were followed up 6 months post-screening. All men completed a pre-screening questionnaire including the Medical Outcomes Short Form 36v 2 (MOSF36) and Hospital Anxiety and Depression Scale (HADS). Six months after screening all 53 men with an abnormal and 130 with a normal aorta were sent a questionnaire including MOSF36 and HADS. Baseline and 6 month scores for both MOSF36 and HADS scores were compared between the two groups and within each group. Baseline scores for both MOSF36 and HADS were not significantly different between men who were subsequently diagnosed with an abnormal aorta and those with a normal aorta. After 6 months there was no difference in HADS scores but a significant increase in the MOSF36 dimension of general health. Those with a normal aorta reported better general health, social functioning andgreater freedom from bodily pain. AAA screening appears highly acceptable to men in the target age group and future research should focus on implementation, cost effectiveness and collateral benefits of AAA screening