Epoetin Alfa Therapy in Infants Awaiting Heart Transplantation

Shaddy, Robert E.; Bullock, Emily A.; Tani, Lloyd Y.; Orsmond, Garth S.; Hunter, Dixie D.; Christensen, Robert D.

doi:10.1001/archpedi.1995.02170150102020

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…Recommendations have not been published for the pediatric population. Studies have evaluated Epo administered to children requiring a variety of major surgical procedures, including open heart surgery, craniosynostosis repair, and corrective spinal surgery [12–20]. In studies of older pediatric patients, autologous blood was collected after children received Epo therapy preoperatively and was used during surgery for blood loss [13–16].…”

Section: Discussionmentioning

confidence: 99%

“…Because of challenges in preoperative autologous blood donation in younger pediatric populations, investigators evaluated single or multiple doses of Epo to stimulate erythropoiesis in infants and children before cardiac surgery [12,19]. Shaddy et al [12] administered Epo to infants awaiting heart surgery and reported a significant increase in hematocrit and reticulocyte count.…”

Section: Discussionmentioning

confidence: 99%

“…Shaddy et al [12] administered Epo to infants awaiting heart surgery and reported a significant increase in hematocrit and reticulocyte count. Ootaki et al [19] administered a single preoperative dose of Epo before cardiac surgery to 82 children.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have been performed in the pediatric surgical population [12–20]; however, the total number of neonates evaluated is minimal. Based on previous studies in preterm neonates, it seemed reasonable to extend the use of Epo to other neonatal populations where the risk of multiple transfusions exist.…”

Section: Introductionmentioning

confidence: 99%

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Erythropoietin increases reticulocyte counts and maintains hematocrit in neonates requiring surgery

Bierer

Roohi

Peceny

et al. 2009

Journal of Pediatric Surgery

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Background Limited erythropoietin (Epo) production diminishes neonates’ ability to regenerate blood removed by phlebotomy. Neonates requiring surgery are at risk to receive multiple transfusions. We sought to determine if recombinant Epo administration to neonates requiring surgery would stimulate erythropoiesis. Methods Infants were randomized in double-masked fashion to receive Epo (200 units kg−1 d−1) or placebo for 14 days. Complete blood count, absolute reticulocyte count (ARC), phlebotomy losses, and transfusions were measured during the study period. Infants were transfused using a strict transfusion protocol. Results In the Epo group (n = 10, 2034 ± 308 g, 8 ± 2 days old; mean ± SEM), ARC increased significantly, whereas in the placebo group (n = 10, 2400 ± 184 g, 7 ± 2 days old), ARC remained low. Hematocrits in the Epo group trended upward from 34.4 ± 1.7% to 37.3 ± 1.9% (although not statistically significant) despite phlebotomy losses of 53 ± 12 mL/kg. Hematocrits in the placebo group were 35.9 ± 1.8% and 33.2 ± 1.6% on days 1 and 15, respectively, with phlebotomy losses of 27 ± 5 mL/kg. There were no differences in absolute neutrophil counts or platelet counts between groups at the end of the study. No adverse effects were noted. Conclusions Infants randomized to Epo increased reticulocyte counts and hematocrits without adverse effects. Erythropoietin administration may provide an adjunct to present care in decreasing or eliminating erythrocyte transfusions in surgical neonates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Erythropoietin increases reticulocyte counts and maintains hematocrit in neonates requiring surgery

Bierer

Roohi

Peceny

et al. 2009

Journal of Pediatric Surgery

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“…4,5 Use of erythropoietin has recently been reported in adults undergoing cardiovascular surgical procedures and in children before or following heart transplantation. [6][7][8] Erythropoietin may offer an effective alternative to the use of homologous blood transfusion in acyanotic children undergoing elective cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Bloodless Pediatric Cardiac Surgery? Deliverance with Erythropoietin

Creery¹,

Black

Adatia

et al. 1998

Asian Cardiovasc Thorac Ann

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A 2-year-old 11.6 kg boy with congenital heart disease whose parents refused homologous blood products was treated preoperatively with iron and human recombinant erythropoietin for 6 weeks. Surgical repair was performed without exposure to blood products other than human albumin. Treatment with iron and erythropoietin in combination with post-bypass modified ultrafiltration, minimization of hemodilution, reinfusion of residual pump prime, and diuresis may reduce or avoid the need for blood transfusion in acyanotic children undergoing elective cardiac surgery.

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Pediatric Heart Transplantation

Lamour¹,

Addonizio²

2004

Cardiac Transplantation

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Epoetin Alfa Therapy in Infants Awaiting Heart Transplantation

Cited by 9 publications

References 14 publications

Erythropoietin increases reticulocyte counts and maintains hematocrit in neonates requiring surgery

Erythropoietin increases reticulocyte counts and maintains hematocrit in neonates requiring surgery

Bloodless Pediatric Cardiac Surgery? Deliverance with Erythropoietin

Pediatric Heart Transplantation

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