Study of Acute Normovolemic Hemodilution (ANH) in People With Ovarian Cancer Who Are Having Cytoreductive Surgery

Inclusion criteria

• Adults (≥18 years)
• BLOODS score ≥2 as calculated by surgeon
• High preoperative suspicion (or diagnosis) of advanced primary epithelial ovarian, fallopian tube, or primary peritoneal carcinoma (stage IIIC or IV), as determined by CT or MRI of the abdomen/pelvis
• Planned for exploratory laparotomy and primary or interval cytoreductive surgery
• Preoperative hemoglobin concentration ≥10 mg/dl within 45 days of surgery
• Patients scheduled for cytoreductive surgery, with or without other planned procedures o Note: Patients scheduled for only diagnostic laparoscopy should not be included

Exclusion criteria

• A history of active coronary artery disease

o Patients with a history of coronary artery disease will be eligible if they have had a cardiac stress study showing no reversible ischemia and normal LV function within 45 days of surgery.

• A history of cerebrovascular disease
• A history of congestive heart failure
• A history of uncontrolled hypertension
• A history of restrictive or obstructive pulmonary disease
• A history of renal dysfunction (Cr >1.6 mg/dl)
• Abnormal coagulation parameters (INR >1.5 not on coumadin, or platelet count <100,000 mcL)
• Presence of active infection
• Evidence of hepatic metabolic disorder (bilirubin >2 mg/dl, ALT >75 U/L in the absence of biliary tract obstruction)
• Preoperative autologous blood donation within last 30 days or plan to donate autologous blood prior to surgery
• Refusal to accept allogenic or autologous blood transfusion
• Patients scheduled for cytoreductive surgery with planned Hyperthermic Intraperitoneal Chemotherapy (HIPEC)