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  Vol. 149 No. 3, March 1995 TABLE OF CONTENTS
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Epoetin Alfa Therapy in Infants Awaiting Heart Transplantation

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

Arch Pediatr Adolesc Med. 1995;149(3):322-325.


Abstract



Objective
To determine the safety and efficacy of epoetin alfa therapy in infants awaiting heart transplantation to minimize the need for blood transfusions.

Design
Prospective case series analysis.

Setting
Pediatric tertiary care center.

Patients
Eleven term infants (4 to 54 days old) awaiting heart transplantation.

Intervention
Infants received 16 courses of daily epoetin therapy and four subsequent courses of alternate-day epoetin therapy.

Results
Daily epoetin therapy was instituted at 23.6±4.5 days of age, and the duration of treatment was 13.8±3.9 days (mean±SEM). During daily epoetin therapy, the hematocrit increased from 0.42±0.015 to 0.50±0.019 (P<.001), and the reticulocyte count increased from 58±9x10–3 to 105±16x10–3(P<.05). There were no significant changes in leukocyte count (13.4±1.0x 109/L vs 15.1±0.9x109/L), platelet count (402±43x109/L vs 387±39x109/L), or creatinine (53±9 µmol/L [0.6±0.1 mg/dL] vs 53±9 µmol/L [0.6±0.1 mg/dL]) (not significant). Four patients received blood transfusions during daily epoetin therapy, but the amount of blood administered to patients was significantly less (0.9±0.5 mL/kg per day) than the phlebotomy losses (1.8±0.4 mL/kg per day) (P<.01). During alternate-day epoetin therapy, the hematocrit decreased from 0.53±0.014 to 0.43±0.019 (P<.05).

Conclusions
Daily epoetin therapy appears to be effective in maintaining stable hematocrit in infants awaiting heart transplantation, who generally require multiple transfusions secondary to iatrogenic blood losses.

(Arch Pediatr Adolesc Med. 1995;149:322-325)



Author Affiliations



From the Department of Pediatrics, Primary Children's Medical Center and the University of Utah, and the UTAH Cardiac Transplant Program, Salt Lake City.



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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Erythropoietin therapy and preoperative autologous blood donation in children undergoing open heart surgery
Sonzogni et al.
Br J Anaesth 2001;87:429-434.
ABSTRACT | FULL TEXT  

Bloodless Pediatric Cardiac Surgery? Deliverance with Erythropoietin
Creery et al.
Asian Cardiovasc. Thorac. Ann. 1998;6:237-238.
ABSTRACT | FULL TEXT  





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