Aims: We decided to investigate the efþcacy of postoperative Epoetin Alfa in decreasing allogenic transfusion exposure in patient who had an mediummajor orthopaedic intervention who could conduct in major loss of blood. Material-Method: Between July 2000-Mars 2002 in our department a trial was conducted comparing the safety and efþcacy of a weekly epoetin alfa dosing regimen (40000⋄4) with a daily regimen (10000⋄15) in patients with hemoglobin levels 9g/dl< Hb< 11g/dl in the 2nd postoperative day after a major orthopaedic procedure. The average age was 28–85y. Results: In the þrst group (24p) there was a increase of the Ht 6units and in the 2nd group 4units. In the þrst group we had a death in the 13een postoperative day from diffuse intravascular coagulation. In both groups the rehabilitation and discharge of the patients were quicker and there was no postoperative transfusion. In 9 cases of the þrst group and only in 2 of the second we observed a enormous augmentation of the platelets (600000–1000000) but without any signs of thrombosis. This point needs more investigation. Conclusion: These data showed the weekly Epoetin Alfa regimen to be at least as efþcacious and more convenient as the daily regimen in the treatmen of the postoperative anaemic patients. More investigation is needed for possible complications.

Introduction: Moderate and major operation concerning trauma or selective procedures (like total ¥2) joint replacement) can lead to considerable amount of blood loss and postoperative anaemia. This loss affects negatively the patients’ postoperative course concerning mortality, morbidity as well as patients’ recovery. We decided to provide these patients with Epoetin Alpha in the early postoperative period to control anaemia.

Material and Methods: In our Department, from July 2000 until March 2002, we treated 42 patients with postoperative anaemia due to moderate or major operations (like hip and femoral fractures, total joint replacements). Patients’ age ranged from 28 to 85 years, hi this study we included all patients with 9g/dl < Hb < 1 Ig/dl on second postoperative day, without coexisted contraindications for administration of Epoetin Alpha. Patients having been transfused due to serious postoperative anaemia were not included in this study. Laboratory tests included full blood count check up to the end of treatment.

Patients were divided in two groups, hi the first group (18 patients) were provided 2 X 10000 units Epoetin Alpha daily for 15 days, hi the second group (after August 2001) we provided 40000 units X 4 every three days, hi all cases we provided Fe per os. One patient (in the second group) sustained diffuse intravascular coagulation (DIG) on the 13th postoperative day and finally she died. In the first group we noticed an increase of Ht by 4 units (mean rate) and in the second group by 6 units. Two cases in the first group presented a slight raise of the Ht (one unit), while the patient who presented DIG belonged to the second group. No patient was transfused postoperatively. Mobilization of patients especially the elderly was earlier than usual. An interesting notice was the raise of platelets (> 600000) in nine cases of the second group and in only two cases of first group, without complications. This raise was attributed to the stimulation of bone marrow due to the fast blood loss during the operation.

Conclusion: The effectiveness and safety of Epoetin Alpha has been proved in many studies concerning selective orthopaedic operations. Update results show that Epoetin Alpha has a significant effect in the treatment of postoperative anaemia. Of course further investigations (like double blind studies and control of potential complications from administration) are mandatory.