Uses of rHuEpo in surgical patients. (A) When the time to surgery is ≥3 weeks, the use of rHuEpo for facilitating autologous blood donation may be considered. Patients are treated with rHuEpo at 250 to 300 IU/kg twice weekly over the 3-week period before surgery. IV iron supplementation (iron saccharate at 200 mg) is administered at each of the six visits before surgery, when the patient donates 1 U of autologous blood (350 mL) if his/her Hct is ≥34%. If IV iron is not available, oral supplementation should involve the administration of at least 200 mg of elemental iron daily (900 mg iron sulphate) and rHuEpo doses should be doubled. (B) When the time to surgery is 2 to 3 weeks or when autologous donations are not possible, a preoperative use may be considered. We suggest SC administration of 6 doses of rHuEpo (250 to 300 IU/kg) and iron supplementation as detailed above in (A). These administrations may be distributed over a variable period, from 10 to 21 days. (C) Alternative protocol for perisurgical use of rHuEpo, based on 4 SC rHuEpo administrations of 600 IU/kg each, every 7 days, starting at surgery day −21.102 Daily oral iron supplementation is provided with 200 mg of elemental iron in the form of a polysaccharide-iron complex (Niferex; Central Pharmaceuticals Inc, Seymour, IN). (D) When time to surgery is 1 week or less, a short perisurgical use of rHuEpo may be considered. The schedule used at the Istituto Ortopedico Gaetano Pini (Milan, Italy) involves SC administration of rHuEpo at a daily dose of 100 IU/kg from preoperative day 4 (day −4) to postoperative day 2 (day +2). On the first day of treatment, one 200 IU/kg bolus is also administered IV. IV iron saccharate is administered concomitantly at a total dose of 600 to 1,000 mg, according to baseline iron stores.