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). This evidence concerns the gene EPO and anemia.