EPO and Cirrhosis: Most nonrenal erythropoietin (EPO) comes from the liver, and the normal liver can synthesize 10% of erythropoietin, but in patients with cirrhosis, owing to poor liver synthesis, decreased testosterone levels, the influence of pro-inflammatory feedback mechanisms, etc., the ability of the liver to synthesize EPO is decreased, which can lead to the occurrence of anemia (38, 39).