Preoperative erythropoietin (epo) increases hematocrit and decreases transfusions in children undergoing craniofac1al surgeries

Introduction: Cranofaoal surgery is a procedure associated with blood loss and transfusions, performed on children less than one year of age to correct abnormalities of skull shape and volume. Because of trie concerns regarding blood transfusions, we conducted a retrospective cohort control study evaluating the efficacy of the administration of EPO to increase hematocrrt and prevent blood transfusion. Methods: With the approval of the internal review board at JHMI, we offered aU families the option of daily iron (6 mg/kg) and EPO 300 U/kg three times per week for 3 pre-operative weeks. Blood transfusions were administered based on the clinical condition of the chud. For comparison, a case matched control population was also evaluated. Results: Thirty patients in each group were evaluated. EPO treatment increased hematocrits from 35.4 ±9% to 43.3 ±9%.whch was hnher than the case matched preoperative hematocrits in the control group (34.2 ±0.5%) p<.05, ANOVA. The number of patients receiving transfusions were greater in control patients (30/30) than in EPO treated patients (19/30). Conclusions: Treatment with EPO in these otherwise healthy young children will increase hematocrit and decrease transfusion requirements.