Erythropoetin accelerates hematocrit recovery in post-surgical anemia.
We evaluated the role of recombinant human erythropoietin (RHE) for treatment of severe postsurgical anemia (Hct < 25%) in 40 Jehovah's Witness (JW) patients refusing transfusion. Twenty patients (group E) received RHE either at a loading dose of 300 U/kg iv 3 times/week for 1 week followed by 150 U/kg 3 times/week in accordance with an IRB approved protocol (N = 13), or at a dose of 100 U/kg 3 times/week for humanitarian reasons (N = 7). This group was compared to 20 similar JW patients who did not receive RHE (group C). All patients received iron restoration and nutritional support. Non-parametric analysis (Mann-Whitney) was used because of sample size. Entry hematocrit was similar for both groups: H(E)(0) = 15.8% +/- 1.1 SEM (8.5-23.4) vs HC (0) = 12.8% +/- 0.9 SEM (7.3-20.6), P = 0.09. After one week, hematocrit was significantly higher in group E (H(E)(1)) = 19.3 +/- 1.1 vs HC(1) = 12.5% +/- 0.9, P < 0.0005) as was the increase in hematocrit for group E (3.6% +/- 0.9 for E vs -0.4% +/- 0.8 for C, P < 0.005). Hematocrit change in Week 2 showed an increase for both groups (2.9 +/- 0.6 for E vs 4.9% +/- 1.2 for C, P = 0.12).


CONCLUSIONS
Hct recovery shows a 1-week lag in severely anemic postsurgical patients treated without RHE. Exogenous RHE appears to accelerate hematocrit recovery in the first week. Use of RHE in the immediate postoperative period may help avoid or reduce homologous blood transfusion.
Atabek
U
U
Department of Surgery, Cooper Hospital/University Medical Center, Robert Wood Johnson Medical School at Camden, New Jersey.
Alvarez
R
R
Pello
M J
MJ
Alexander
J B
JB
Camishion
R C
RC
Curry
C
C
Spence
R K
RK
D000740:Anemia / Q000097:blood / Q000188:drug therapy*; D001803:Blood Transfusion; D002835:Christianity; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006400:Hematocrit; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support; D011183:Postoperative Complications / Q000097:blood / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors; D016312:Treatment Refusal
D011994:Recombinant Proteins; D004921:Erythropoietin