Recombinant human erythropoietin administration in cardiac surgery

Objective: Postoperative anemia and multiple blood transfusions are still i mportant problems in cardiac surgery. During the past few years, there have been some reports indicating that multiple recombinant human erythropoieti n infusions starting at least 2 weeks before the operation induced erythrop oiesis. We aimed to reduce the risk of adverse reactions of high doses of r ecombinant human erythropoietin and reduce the period of hospitalization by using it only once, 4 days before the operation. Methods: Twenty-five patients received recombinant human erythropoietin 4 d ays before the operation, and 28 patients comprised the control group. All the hematologic parameters of the patients are measured on the day of admis sion, the day before the operation (fourth day), the first day after the op eration, and 1 week later. Results: 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 con trol 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 h uman erythropoietin group, whereas 680 +/- 75 mL was required in the contro l group (P <.01). Conclusion: Recombinant human erythropoietin induces erythropoiesis rapidly , even when it is used with a low single dose just 4 days before the operat ion. No adverse reactions were seen with this kind of recombinant human ery thropoietin treatment.