SERUM IMMUNOREACTIVE ERYTHROPOIETIN DURING THE PERIOPERATIVE PERIOD

Background. Recombinant human erythropoietin is now available for clin ical use. Therefore we sought to determine the frequency of anemia and low endogenous erythropoietin levels in patients undergoing elective, major general surgical procedures. Methods. Serum immunoreactive eryt hropoietin levels were measured before operation and 1 and 5 days afte r operation in 84 patients (43 men and 41 women) with normal renal fun ction. Results. Twenty of the women (49%) and 27 of the men (63%) were anemic before operation. Nine of these anemic patients had inappropri ately low serum erythropoietin levels for their degree of anemia. On p ostoperative day 1, 66% of the women and 88% of the men were anemic, b ut the mean serum erythropoietin level had not increased. On postopera tive day 5, 80% of the women and all of the men were anemic, but 22% o f the patients still had an inappropriately low serum erythropoietin l evel. Multiple regression analysis identified female gender and black ancestry as predictors of an inadequate erythropoietin response after operation. Conclusions. Diseases requiring operation are frequently as sociated with anemia that is in part caused by impaired erythropoietin production. Surgery also appears to contribute to suppression of eryt hropoietin production particularly in women and black persons.