Epoetin alfa therapy in infants awaiting heart transplantation.
OBJECTIVE
To determine the safety and efficacy of epoetin alfa therapy in infants awaiting heart transplantation to minimize the need for blood transfusions.


METHODS
Prospective case series analysis.


METHODS
Pediatric tertiary care center.


METHODS
Eleven term infants (4 to 54 days old) awaiting heart transplantation.


METHODS
Infants received 16 courses of daily epoetin therapy and four subsequent courses of alternate-day epoetin therapy.


RESULTS
Daily epoetin therapy was instituted at 23.6 +/- 4.5 days of age, and the duration of treatment was 13.8 +/- 3.9 days (mean +/- SEM). During daily epoetin therapy, the hematocrit increased from 0.42 +/- 0.015 to 0.50 +/- 0.019 (P < .001), and the reticulocyte count increased from 58 +/- 9 x 10(-3) to 105 +/- 16 X 10(-3) (P < .05). There were no significant changes in leukocyte count (13.4 +/- 1.0 X 10(9)/L vs 15.1 +/- 0.9 X 10(9)/L), platelet count (402 +/- 43 X 10(9)/L vs 387 +/- 39 X 10(9)/L), or creatinine (53 +/- 9 mumol/L [0.6 +/- 0.1 mg/dL] vs 53 +/- 9 mumol/L [0.6 +/- 0.1 mg/dL]) (not significant). Four patients received blood transfusions during daily epoetin therapy, but the amount of blood administered to patients was significantly less (0.9 +/- 0.5 mL/kg per day) than the phlebotomy losses (1.8 +/- 0.4 mL/kg per day) (P < .01). During alternate-day epoetin therapy, the hematocrit decreased from 0.53 +/- 0.014 to 0.43 +/- 0.019 (P < .05).


CONCLUSIONS
Daily epoetin therapy appears to be effective in maintaining stable hematocrit in infants awaiting heart transplantation, who generally require multiple transfusions secondary to iatrogenic blood losses.
Shaddy
R E
RE
Department of Pediatrics, Primary Children's Medical Center, Salt Lake City.
Bullock
E A
EA
Tani
L Y
LY
Orsmond
G S
GS
Hunter
D D
DD
Christensen
R D
RD
D000740:Anemia / Q000517:prevention & control*; D001803:Blood Transfusion; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000627:therapeutic use*; D005240:Feasibility Studies; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery; D016027:Heart Transplantation; D006400:Hematocrit; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use
D011994:Recombinant Proteins; D004921:Erythropoietin