Effects of Recombinant Human Erythropoietin Therapy on Blood Coagulation and Fibrinolysis System

Toshiya Kobayashi, MD,1 Haruo Makuuchi, MD,1 Kouki Takahashi, MD,2 Akira Furuse, MD,3 Yoichi Shibata, MD,4 Hirokazu Tsuno, MD,4 Yutaka Kotsuka, MD,5 Hiroshi Kubota, MD,5 Kazuhito Imanaka, MD,5 Toshiyasu Tsukada, MD,6 and Mitsuyoshi Nakashima, MD7

This study was designed to examine the effects of recombinant human erythropoietin (rHuEPO) therapy on blood coagulation and fibrinolysis in patients scheduled for elective heart surgery and undergoing preoperative autologous blood donation. Twenty-seven patients were studied, of whom 16 patients received rHuEPO (group E) and 11 patients no rHuEPO therapy (group N). The patients in group E were given 6000 units of rHuEPO intravenously every other day, three times a week, beginning from two weeks prior to the operation. In both groups, 400 ml of blood was collected preoperatively for predeposit once a week for two weeks, and the self-donated blood was returned to the patient intra- and postoperatively. Blood samples were drawn at the beginning of the study, immediately before the operation and two weeks after the operation. They were analyzed to assess blood coagulation, fibrinolysis, platelet function and vascular endothelial cell function, in order to examine the effects of the administration of rHuEPO. No significant difference was observed between the two groups in the degree of changes in these parameters following the operation. As enhancement of blood coagulability and fibrinolytic activity was evident postoperatively in both groups, changes in these parameters during the preoperative autologous blood donation period were also assessed excluding the postoperative data. Again, there was no significant intergroup difference in any of the markers evaluated. It was concluded that the administration of rHuEPO during preoperative autologous blood donation is unlikely to affect coagulation and fibrinolysis. (Ann Thorac Cardiovasc Surg 2001; 7: 273-277)

Key words: erythropoietin, blood coagulation, fibrinolysis, heart surgery, autologous blood donation

From the Departments of 1Cardiovascular Surgery and 2Immunohematology, Toranomon Hospital, 3JR Tokyo General Hospital, Departments of 4Transfusion Medicine and 5Cardiothoracic Surgery, University of Tokyo, 6Chuo University Health Center, and 7Hamamatsu University School of Medicine, Japan

Received January 29, 2001; accepted for publication May 21, 2001
Address reprint requests to Toshiya Kobayashi, MD: Department of Cardiovascular Surgery, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo 105-0001, Japan.