title: Erythropoietin response to anaemia is not altered by surgery or recombinant human erythropoietin therapy.
abstract: Recombinant human erythropoietin (EPO) therapy has been shown to increase red blood cell (RBC) production and facilitate autologous blood donation before elective surgery. However, recent reports have suggested that surgery and/or EPO therapy may suppress endogenous erythropoietin secretion in response to anaemia. We therefore analysed the haemoglobin/erythropoietin relationship preoperatively and postoperatively in 71 autologous blood donors subjected to aggressive phlebotomy and six treatments with either EPO (150 U/kg, n = 16, 300 U/kg, n = 18, or 600 U/kg, n = 19) or placebo (n = 18). Using data from the three preoperative study visits, the linear relationship between log erythropoietin and haemoglobin was determined for each of the 18 placebo patients. We found no significant differences in the slopes of the relationships in this group during aggressive phlebotomy. Furthermore, there was no evidence of a significant difference in the erythropoietin level recorded postoperatively for each patient to that predicted from the patient's postoperative haemoglobin level, based on the haemoglobin/log erythropoietin relationship preoperatively. Similarly, for each of the EPO-treated groups, there was no evidence of a significant difference when comparing the recorded erythropoietin level to that predicted from each patient's postoperative haemoglobin level, based on the haemoglobin/log erythropoietin relationship preoperatively. We conclude that preoperative recombinant human erythropoietin therapy and/or surgery do not adversely affect the postoperative erythropoietin response to anaemia.
authors.affiliation: Washington University School of Medicine, Division of Laboratory Medicine, St Louis, MO 63110.
authors.forename: L T
authors.initials: LT
authors.lastname: Goodnough
authors.forename: T H
authors.initials: TH
authors.lastname: Price
authors.forename: C A
authors.initials: CA
authors.lastname: Parvin
authors.forename: K D
authors.initials: KD
authors.lastname: Friedman
authors.forename: W R
authors.initials: WR
authors.lastname: Vogler
authors.forename: N
authors.initials: N
authors.lastname: Khan
authors.forename: R
authors.initials: R
authors.lastname: Sacher
authors.forename: M
authors.initials: M
authors.lastname: Johnston
authors.forename: M
authors.initials: M
authors.lastname: Wissel
authors.forename: D
authors.initials: D
authors.lastname: Ciavarella
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood* / Q000209:etiology / Q000628:therapy; D001804:Blood Transfusion, Autologous; D001815:Bloodletting; D004311:Double-Blind Method; D004921:Erythropoietin / Q000097:blood* / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011994:Recombinant Proteins / Q000627:therapeutic use; D013514:Surgical Procedures, Operative
chemical_list: D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin