Acute bleeding in patients who refuse transfusion: Role of erythropoietin – pro

Acute bleeding in patietns who refuse transfusion is a difficult clinical challenge. There is some avidence that recovery is enchanced by adminsitering erytropoietin but it is preliminary, recent and inconclusive. One study of post-ulcer bleeding anemia concluded that Erythropoietin administration significantly accelerates correction of anemia after acute ulcer bleeding. The haematocrit gain is equivalent to one unit of transfused blood two weeks after the bleeding episode. In this small retrospective  study bleeding ceased and was not continuing at the time of erythropoeitin adminstration. Erythropoietin is often used in acutely bleeding patients who refuse transfusion but this strategy is not supported by credible literature and is of doubtful benefit.

Mann, MC, Votto, J, Kambe, J, et al Management of the severely anemic patient who refuses transfusion: lessons learned during the care of a Jehovah’s Witness. Ann Intern Med 1992;117,1042-1048

Cothern, C, Moore, EE, Offner, PJ (2002) Blood substitute and erythropoietin therapy in a severely injured Jehovah’s Witness. N Engl J Med 346,1097-1098

Pousada L, Fiorito J, Smyth C.Erythropoietin and anemia of gastrointestinal bleeding in a Jehovah’s Witness.Ann Intern Med. 1990 Apr 1;112(7):552.

Ladas SD, Polymeros D, Pagonis T, Triantafyllou K, Paspatis G, Hatziargiriou M, Raptis SA.
Does recombinant human erythropoietin accelerate correction of post-ulcer-bleeding anaemia? A pilot study.World J Gastroenterol. 2004 Feb 15;10(4):586-9.

Participate in our Forums

To ask questions or participate in a discussion, please visit our Forums. You must LOGIN to participate.

Help Us Help Others

You can become a Site Sponsor. Or you may wish to support our work with a Donation.

Focused Articles For You

Lay Portal