Are there "general" recommendations for preoperative EPO use in JW patients based on age, comorbid conditions, preoperative Hct, and surgical procedure planned?
FDA guidelines for general, non-cardiac or vascular surgery with Hb of 10-13 grams/dl should receive 40,000 per week 3 weeks prior to surgery and one injection on the day of surgery. Although the FDA guidelines do not expressly state this, it seems logical to give the same regimen to those with lower hemoglobin. Remember that small doses of supplemental iron and folate should be added.
Aryeh Shander, MD, FCCM, FCCP