What is the role of erythropoietin in preventing heterologous transfusions in liver transplantation?

Updated: Apr 19, 2019
  • Author: Vanessa A Olcese, MD, PhD; Chief Editor: Ron Shapiro, MD  more...
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Answer

Answer

Erythropoietin is a safe and effective drug for acute blood-loss anemia, although it requires time to work. It can be used preoperatively in patients who are scheduled to undergo surgery, and it can be used postoperatively to stimulate bone marrow stem cells to produce erythrocytes more quickly. Used in conjunction with intravenous iron, erythropoietin can effectively enhance erythropoiesis.

Erythropoietin also was used in a Jehovah's Witness patient who underwent OLT for biliary cirrhosis. [47] Preoperative total hemoglobin levels increased from 11.1 mg/dL to 14 mg/dL within 5 weeks of erythropoietin treatment (2000 IU/d for 5 or 7 d). In lieu of packed red blood cell (PRBC) transfusion, the patient was treated with meticulous hemostasis, argon-beam coagulation, continuous autotransfusion of salvaged blood, tranexamic acid, and transfusion of both platelets and cryoprecipitate.


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