Managing preoperative anemia: EPO is needed

Abstract

Erythropoietin (EPO) is one of the treatments available for managing preoperative anemia and has now been included in several international recommendations on Patient Blood Management, particularly in major orthopedic and cardiac surgeries. Iron deficiency being the leading cause of anemia, iron supplementation is often the first-line treatment prescribed by clinicians; however, it frequently fails to raise hemoglobin levels enough to correct preoperative anemia or reduce perioperative transfusion needs. Here, we discuss the benefits and potential risks of preoperative EPO use as shown or observed in studies, particularly its superior effectiveness compared to iron alone for correcting anemia and reducing transfusion, and we present the clinical situations in which its use should be considered to improve patient outcomes.