ERYTHROPOIETIN ACCELERATES HEMATOCRIT RECOVERY IN POSTSURGICAL ANEMIA

We evaluated the role of recombinant human erythropoietin (RHE) for tr eatment of severe postsurgical anemia (Hct < 25%) in 40 Jehovah's Witn ess (JW) patients refusing transfusion. Twenty patients (group E) rece ived RHE either at a loading dose of 300 U/kg iv 3 times/week for 1 we ek followed by 150 U/kg 3 times/week in accordance with an IRB approve d protocol (N = 13), or at a dose of 100 U/kg 3 times/week for humanit arian reasons (N = 7). This group was compared to 20 similar JW patien ts who did not receive RHE (group C). All patients received iron resto ration and nutritional support. Non-parametric analysis (Mann-Whitney) was used because of sample size. Entry hematocrit was similar for bot h groups: H-E(0) = 15.8% +/- 1.1 SEM (8.5-23.4) vs H-C(0) = 12.8% +/- 0.9 SEM (7.3-20.6), P = 0.09. After one week, hematocrit was significa ntly higher in group E (H-E(1) = 19.3% +/- 1.1 vs H,(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% a 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% C 1. 2 for C,P = 0.12). Conclusions: Hct recovery shows a 1-week lag in sev erely anemic postsurgical patients treated without RHE. Exogenous RHE appears to accelerate hematocrit recovery in the first week. Use of RH E in the immediate postoperative period may help avoid or reduce homol ogous blood transfusion.