Preoperative autologous blood donation (PABD) is widely practised in elective orthopaedic surgery, but few data are available as regards recombinant human erythropoietin (rHuEpo) support during a PABD programme in children.

In January 1999 we introduced a PABD protocol with erythropoietin (10000 U s.c. twice weekly during the 3 weeks preceding surgery) in children who were scheduled for corrective surgery of scoliosis. Between January 1999 and November 2003, 23 consecutive patients (five males and 18 females, median age 15.1 years) were enrolled. Preoperative haemoglobin (Hb) levels, the numbers of collected and of autologous and allogeneic blood transfused units were determined. The results were compared with a historical group of 28 consecutive patients (seven males and 21 females, median age 15.4 years) who underwent spinal surgery between January 1994 and December 1998 and who differed from the first group only by the absence of concomitant erythropoietin therapy.

Administration of rHuEpo allowed all patients to complete the PABD programme, whereas 36% of patients in the non-treated group had to stop predeposit because they developed anaemia. Furthermore, significantly higher numbers of collected blood units and haemoglobin levels were measured. A significantly lower requirement for allogeneic blood was observed in the rHuEpo-treated group: 1/23 vs. 9/28 patients (4.3%–32.1%, p < 0.001).

The present study documents the efficacy of presurgical rHuEpo in facilitating autologous blood collection, thus reducing exposure to allogeneic blood, in paediatric patients undergoing corrective spinal surgery.