Perisurgical Intravenous Iron Therapy

SUMMARY There is no doubt that the developments in detecting viral antigens and antibodies, and very recently viral RNA or DNA, in donor blood, have greatly increased the safety of blood transfusion 1 . However, while it is generally agreed that a residual risk of transmitting viral infections by blood still exists 2 , we do not know if Creutzfeld‐Jakob disease or its new form – undetectable with current screening methods – are transmitted by transfusion or not 3 . Furthermore, the long‐term immunomodulatory effect of allogeneic blood on the patient is not known. For these reasons, a more conservative transfusion practice is advocated; physicians must do all they can to decrease allogeneic blood transfusion, especially in patients without blood disease who, because of a significant acute blood loss (e.g. during major surgery), are likely to receive allogeneic blood. In this paper we will discuss the use of intravenously administered iron in the perisurgical setting as a means of accelerating erythropoiesis in an attempt to decrease transfusion requirements.