Yet, it is of concern that only 15.8% of the patients received tranexamic acid despite 26 patients presenting with a history of acute blood loss and strong evidence confirming that tranexamic acid limits blood loss.25 No patient received erythropoietin despite its benefit in patients with renal failure,1 which was the admission diagnosis in 13.9% of transfusion episodes. Here, EPO is linked to Renal insufficiency.