Partial splenectomy prevents splenic sequestration crises in sickle cell disease

Laura R. Vick, John R. Gosche, Saleem Islam

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Purpose: Acute splenic sequestrations (SSs) are potentially fatal complications in sickle cell disease (SCD). Total splenectomies in young patients may predispose them to a higher risk of overwhelming infections, whereas partial splenectomy may maintain immunocompetence. We present our series of partial splenectomies in patients with multiple SS episodes. Methods: We retrospectively reviewed the records of 6 patients who underwent open partial splenectomies for SS. Data on their clinical courses were collected and analyzed. Results: None of the 6 patients had SS postprocedure, down from 2.1 ± 1.0 (P = .003) sequestrations per year and 3.5 ± 1.4 (P = .002) total sequestrations per patient. The transfusion requirements were significantly reduced postoperatively (10.2 ± 5.6 vs 2.0 ± 3.1 per year; P = .002). There was no increase in the infection-related hospital admissions during the period of follow-up (1.5 ± 1.8 vs 0.8 ± 0.8 per year after partial splenectomy; P = .363). The upper pole was preserved in all cases with blood supply off the main splenic artery. Conclusions: Partial splenectomy decreases the risk of SS in SCD and reduces the need for blood transfusions. Infection rates did not increase after the procedure during the follow-up period. Partial splenectomy should be considered for patients who experience multiple acute SS crises or have long-term transfusion requirements.

Original languageEnglish
Pages (from-to)2088-2091
Number of pages4
JournalJournal of Pediatric Surgery
Volume44
Issue number11
DOIs
Publication statusPublished - Nov 2009
Externally publishedYes

Keywords

  • Long-term transfusion
  • Partial splenectomy
  • Sickle cell disease
  • Splenic sequestration

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