Original article

Vol. 21 No. 4 (2023): Blood Transfusion 4-2023 (July-August)

Benefits of pre-operative oral Sucrosomial® iron supplementation in cardiac surgery: influence of patient’s baseline hemoglobin and gender


Key words: cardiac surgery, pre-operative anemia, iron supplementation, blood transfusion, patient blood management
Publication Date: 2022-11-25


Background - The prevalence of low pre-operative hemoglobin (Hb) among cardiac surgery patients is high. As iron homeostasis is often impaired in these patients, restoration of iron availability might over-ride iron-restricted erythropoiesis. This post-hoc analysis of a previously published, large, randomized clinical trial (ClincalTrials.gov NCT03560687; n=1,000) assesses which sub-cohort of patients benefits the most from pre-operative Hb optimization with oral Sucrosomial® iron.
Materials and methods - Patients without baseline Hb (n=349) or receiving >5 red blood cell units (n=57) were excluded from the study. Data from the remaining 594 were reanalyzed according to treatment, baseline anemia (Hb <13 g/dL) or gender. Patients (pt) received a one-month course of 60 mg/day Sucrosomial® iron (Iron group, n=309) or routine care (Control group, n=285) prior to elective cardiac surgery. Main end-point variables were increase in Hb from randomization to hospital admission, transfusion requirements, and cost-effectiveness of Sucrosomial® iron administration.
Results - At hospital admission, Hb had increased 0.7 g/dL and 0.1 g/dL, for Iron and Control groups, respectively (p<0.001), with no gender-related differences, leading to a decrease in transfusion rate (30 vs 59%, respectively; p<0.001) and transfusion index (0.5 units/patient vs 1.2 units/pt, respectively; p<0.001). Sucrosomial® iron administration was well-tolerated, and yielded cost-savings of ?92/pt (p<0.001), particularly in those presenting with baseline Hb <13 g/dL.
Conclusions - This post-hoc analysis confirms pre-operative Sucrosomial® iron administration is a safe and cost-effective strategy to increase pre-operative Hb and decrease transfusion requirements in elective cardiac surgery, especially in those anemic at baseline.



Luca P. Weltert - Heart Surgery, European Hospital, Rome, Italy https://orcid.org/0000-0001-6094-8280

Alessandro De Rosa - Transfusion Medicine Department "San Camillo Forlanini" Hospital, Rome, Italy

Maria B. Rondinelli - Transfusion Medicine Department "San Camillo Forlanini" Hospital, Rome, Italy; https://orcid.org/0000-0002-6393-202X

Mauro Falco - Anesthesiology Department, European Hospital, Rome, Italy

Franco Turani - Anesthesiology Department, "Aurelia" Hospital, Rome, Italy https://orcid.org/0000-0003-2171-6342

Luca Pierelli - Transfusion Medicine Department "San Camillo Forlanini" Hospital, Rome, Italy

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