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Ann Thorac Surg 1991;51:764-766
© 1991 The Society of Thoracic Surgeons

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Articles

Erythropoietin deficiency after coronary artery bypass procedures

^a Department of Surgery, Michael Reese Hospital and Medical Center, Chicago, Illinois USA
^b Department of Surgery, The Amgen Corporation, Thousand Oaks, California USA

Accepted for publication December 31, 1990.

^_* Address reprint requests to Dr Levine, Department of Surgery, Michael Reese Hospital and Medical Center, Lake Shore Drive at 31st St, Chicago IL 60616.

Erythropoietin is the primary regulator of erythropoiesis. Erythropoietin has been shown to increase exponentially in response to linear decreases in hematocrit in normal, unstressed animals. However, the effect of operation, with its attendant stress, on erythropoietin levels is unknown. The purpose of this study is to evaluate the effect of surgical stress on erythropoietin. Twenty otherwise healthy patients scheduled for elective surgical procedures were studied. The cholecystectomy group included 10 patients who underwent cholecystectomy for documented stone disease. Ten patients who underwent coronary artery bypass procedures constituted the coronary artery bypass grafting group. Patients were studied preoperatively as well as on the first and second postoperative days. The hematocrit and erythropoietin levels were similar in both groups preoperatively. The hematocrit in the coronary artery bypass grafting group was lower than that of the cholecystectomy group on postoperative day 1 (0.31 versus 0.36; p < 0.003) and postoperative day 2 (0.30 versus 0.36; p < 0.001). During the first two postoperative days the erythropoietin levels were similar between groups. The data show that postoperative erythropoietin levels are similar after coronary artery bypass grafting, despite more severe anemia, when compared with cholecystectomy. This suggests that after coronary artery bypass grafting there is a relative deficiency of erythropoietin. Administration of recombinant human erythropoietin to patients undergoing surgical procedures could correct the erythropoietin deficiency and accelerate postoperative erythropoiesis.

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