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 byCT 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 plannedprocedures o Note: Patients scheduled for only diagnostic laparoscopy should not beincluded

Exclusion Criteria:

• A history of active coronary artery disease o Patients with a history of coronary artery disease will be eligible if they havehad a cardiac stress study showing no reversible ischemia and normal LV functionwithin 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 theabsence of biliary tract obstruction)

• Preoperative autologous blood donation within last 30 days or plan to donateautologous blood prior to surgery

• Refusal to accept allogenic or autologous blood transfusion

• Patients scheduled for cytoreductive surgery with planned HyperthermicIntraperitoneal Chemotherapy (HIPEC)