Managing anemia in gynecologic surgery with postoperative administration of recombinant human epoetins

To investigate whether postoperative administration of erythropoietin can safely augment in the rapid restoration of hemoglobin (Hgb) values following major gynecologic surgery.

Thirty-three women were enrolled. They had all undergone gynecologic surgery due to malignant or non-malignant reasons. Because of chronic blood loss, many of these patients were iron depleted. Examinations of hematology, serum chemistry and urinalysis values were obtained. Subcutaneous administration of r-HuEPO, in a dosage of 40,000 IU was initiated on the first postoperative day. One additional injection of 40,000 IU was given on the fourth day after surgery. Contemporarily the patients received orally a polysaccharide-iron complex.

During the early postoperative period three patients that were transfused due to severe anemia and one more that was lost in follow-up were excluded from the study analysis. The remaining 29 patients showed a considerable rise in Hgb counts that reached a median value of 1.9 g/dl within a 20-day period.

The postoperative administration of r-HuEPO in gynecologic surgery in patients where autologous blood transfusions can be avoided is challenging, since it can guarantee an uneventful postoperative period with rapid resuscitation without posing the patient to the well-established risks of transfusions.