Use of preoperative erythropoietin in head and neck surgery

To determine whether preoperative erythropoietin can raise the hemoglobin levels of head and neck cancer patients prior to major ablative surgery.

Prospective, consecutive series.

Ten patients who were to undergo major head and neck surgery were scheduled to receive subcutaneous doses of erythropoietin (600 IU/kg) on days 21, 14, 7, and 1 prior to surgery. Serial hemoglobin levels and reticulocyte counts were obtained throughout the course of treatment.

Eight patients experienced a significant increase in hemoglobin. There were two nonresponders. The mean preoperative hemoglobin level for all 10 patients increased 12.6 g/L, from 135.5 +/- 16.2 g/L (baseline) to 148.1 +/- 23.7 g/L (1 day preoperatively, p < .0001).

Erythropoietin significantly increases hemoglobin levels in patients awaiting major head and neck oncologic surgery. It can be viewed as an important adjunct to other well-established blood conservation techniques aimed at reducing perioperative transfusion rates.