ABSTRACT
Erythropoietin (EPO) therapy has been approved for use as a blood conservation intervention, beginning in 1989 for patients with medical anemia and in 1997 for surgical patients. Additional pharmacological agents that mimic the activities of thrombopoietin at the c-Mpl receptor can be designed. Thrombopoietin is the hematopoietic growth factor responsible for megakaryocytic growth, development, and platelet production. EPO-stimulated erythropoiesis is independent of age and gender, and the variability in response among patients is in part due to iron-restricted erythropoiesis. EPO therapy, with or without autologous blood procurement, is undergoing new scrutiny as an alternative to blood transfusion, not only because of traditional concerns regarding blood risks but also because of new blood inventory and cost considerations. The United States blood supply is the safest it has ever been, owing to the evolution of a combination of donor education, donor screening, and new laboratory test procedures.
