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Implications of recombinant erythropoietin therapy for renal transplantation.

We previously reported on the efficiency by which endogenous erythropoietin production corrects anemia after successful renal transplantation. Recent clinical experience with recombinant human erythropoietin in renal failure has demonstrated major benefit in correcting anemia with few adverse consequences. This article reviews our experience to date with recombinant human erythropoietin use in transplant recipients and explores the impact of therapy for the dialysis population awaiting transplantation. The issues of ongoing need for pretransplant blood transfusion, presensitization, organ transplant demand, therapeutic use of human recombinant erythropoietin for chronic rejection, and impact of an expanding, high-quality transplant recipient pool are discussed in the context of the recombinant erythropoietin era.