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Ann Thorac Surg 1997;64:1579-1580
© 1997 The Society of Thoracic Surgeons

Editorial

Erythropoietin Therapy in Patients Undergoing Cardiac Operations

Lawrence T. Goodnough, MD, George J. Despotis, MD, Curtis A. Parvin, PhD

Departments of Medicine, Pathology, and Surgery, Washington University School of Medicine, St. Louis, Missouri

The first 20% of the full text of this article appears below.

Nearly 7 years ago, several investigators described the use of recombinant human erythropoietin (EPO) therapy in patients undergoing cardiothoracic operations [1–3], making this new method of blood conservation a promising advance toward the goal of minimizing allogeneic blood exposure for patients in this setting [4]. Indeed, EPO therapy has subsequently been approved for use in the perioperative setting for patients undergoing autologous blood donation in Japan, the European Union, and Canada, and for use as adjuvant therapy (without autologous blood) in anemic (hematocrit <=39%) patients undergoing major surgical procedures in Canada [5]. In the United States, however, approval for EPO therapy in the surgical setting is limited to use as adjuvant therapy in anemic patients who undergo noncardiac, nonvascular surgical procedures. In this issue of The Annals of Thoracic Surgery, D'Ambra and colleagues [6] report the results of a multicenter United States study of adjuvant EPO therapy in patients undergoing coronary artery bypass grafting. Using an 8-day regimen of EPO (300 U/kg or 150 U/kg subcutaneously) beginning 5 days before the operation, D'Ambra and colleagues conclude that although the EPO-treated patients demonstrated reticulocyte responses and increased levels of hematocrit when compared with placebo-treated patients, the difference in percentage of patients exposed to allogeneic blood in the placebo group (48%) compared with EPO patients (32% and 28% at 300 U/kg and 150 U/kg, respectively) was not statistically significant (p = 0.068) . . . [Full Text of this Article]


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Effect of Recombinant Human Erythropoietin on Transfusion Risk in Coronary Bypass Patients
Michael N. D'Ambra, Richard J. Gray, Robert Hillman, James W. Jones, Hugh C. Kim, Robert Rawitscher, Harold Schnaper, Irma Szymanski, Gus J. Vlahakes, David Kaplan, Karen E. Lynch, Mary Guilfoyle, and Robert I. Abels
Ann. Thorac. Surg. 1997 64: 1686-1693. [Abstract] [Full Text]



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