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Your blood - bank on it.

"Innocent bystanders" in the AIDS epidemic-i.e., those who acquire the disease from a blood transfusion rather than antisocial behavior-continue to crop up despite more stringent efforts to tighten blood banking procedures. As a result, increasing emphasis is being placed on banking one's own blood before surgery is required. Obviously, this is not possible for emergency surgery, but for those undergoing an elective procedure, several units of blood can be drawn in the weeks just prior to surgery. Unfortunately, there are two limiting factors: the length of time blood can be kept in the blood bank and the rate at which the donor can replace his own red cells without becoming anemic.

Previously, it was thought that nothing could be done about speeding up the process of red cell regeneration because red cells are produced in the bone marrow, of which the human body only has so much. Now, however, it seems that our kidneys have a lot to do with the process because of a hormone they produce called erythropoietin. When the kidneys sense that the level of circulating red cells has decreased, they send this hormone into the bloodstream to stimulate the bone marrow to produce more cells. Genetic engineering can now produce erythropoietin for patients with chronic kidney failure, almost all of whom develop anemia. If it could also be used in normal persons about to undergo surgery, it could have a double-barreled benefit. First, it would allow patients to predonate larger quantities of blood; second, they would also have more red blood cells at the time of surgery.

Initial studies on this use of erythropoietin are now underway at Case Western Reserve University in Cleveland, where high doses of the hormone have been found to increase the average blood predonation from 4 units to 5.4 units. Iron, essential to red cell production, is also given in the process. The hormone is expensive, however: about $2,500 per patient. If further studies show that smaller doses will achieve the same result, this will significantly lower the cost-as will increased production if these studies successfully create an increased demand for the product.

If you are facing surgery, and your doctor finds your general health to be compatible for predonating blood, he might suggest that alternative. If he doesn't, ask about it.
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Title Annotation:for elective surgery
Publication:Medical Update
Date:Mar 1, 1990
Words:384
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