Recombinant human erythropoietin administration in cardiac surgery

Postoperative anemia and multiple blood transfusions are still important problems in cardiac surgery. During the past few years, there have been some reports indicating that multiple recombinant human erythropoietin infusions starting at least 2 weeks before the operation induced erythropoiesis. We aimed to reduce the risk of adverse reactions of high doses of recombinant human erythropoietin and reduce the period of hospitalization by using it only once, 4 days before the operation.

Twenty-five patients received recombinant human erythropoietin 4 days before the operation, and 28 patients comprised the control group. All the hematologic parameters of the patients are measured on the day of admission, the day before the operation (fourth day), the first day after the operation, and 1 week later.

In the recombinant human erythropoietin group the mean hemoglobin concentration increased on the morning of the operation (14.5 +/- 0.52 g/dL in the recombinant human erythropoietin group and 12.4 +/- 0.65 in the control group, P <.05). To maintain hemoglobin levels at greater than 8.5 g/dL, 330 +/- 33 mL of homologous transfusion was required in the recombinant human erythropoietin group, whereas 680 +/- 75 mL was required in the control group (P <.01).

Recombinant human erythropoietin induces erythropoiesis rapidly, even when it is used with a low single dose just 4 days before the operation. No adverse reactions were seen with this kind of recombinant human erythropoietin treatment.