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As far as I know, just leg bones produce red blood cells. So, how people who lost their both legs produce red blood cells?

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Can you point to a reference? Any bone with sufficient marrow can produce erythrocytes. It may be that the largest number are made in the femur and tib/fib, but they aren't exclusively the point of production. – jonsca Jun 20 '13 at 9:27
up vote 18 down vote accepted

Red blood cells are produced in the red marrow which...

"is found mainly in the flat bones, such as the pelvis, sternum, cranium, ribs, vertebrae and scapulae, and in the cancellous ("spongy") material at the epiphyseal ends of long bones such as the femur and humerus." - Wikipedia

So you are partly right; the femur is associated with red blood cell production, or Erythropoiesis to give it it's technical name, but there are other bones within the human body that also do this job. The process of erythropoiesis is stimulated when the kidneys detect low levels of oxygen in the blood stream and stimulate production of the hormone erythropoietin. Further, the role of the tibia and femur in erythropoiesis also decreases with age whereas...

"the vertebrae, sternum, pelvis and ribs, and cranial bones continue to produce red blood cells throughout life." - again from the wiki page

So I'd suggest it is unlikely that loss of the legs would have a major impact on the production of red blood cells in adults. I imagine that with the loss of legs comes some reduction in functionality of erythropoiesis but also a lower requirement of red blood cell production (less blood capacity = less blood cells needed = less blood cells need to be produced). I can't find any studies which explore the ability or needs of amputees and non-amputees with regards to red blood cell production.

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While researching earlier I did find some reports on post-amputation anaemia. Clearly the compensation by other bones does not always work, but this was a minority of only about 7% iirc. – Armatus Jun 20 '13 at 10:54
@Armatus Thanks, I guess people will be affected differently, I couldn't find any evidence of prolonged problems myself but did find cases of transfusions being required in the days/weeks after surgery but that is probably more related to the blood loss and maybe the other bones "learning" to compensate. – rg255 Jun 20 '13 at 11:30

Red blood cells are produced in the red marrow, and white blood cells are produced in the yellow marrow. The marrow is found in the flat bones (i.e.long bones) which is the pelvis, sternum, ribs, and vertebrae. If the long bones are no longer attached the the pelvis and the ribs with have to work harder in order to produce the blood cells needed.

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can you give a source for that information? Also, see comments on question that are listed above. – Vance L Albaugh Mar 4 at 18:59

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