Can partial splenectomy preserve humoral immunity in pediatric patients? Risks and benefits of partial splenectomy

Abstract

The spleen plays an important role in removing normal and abnormal cells from the blood and in providing an immunologic response to encapsulated bacteria. Surgical splenectomy provides effective treatment for several pediatric disorders, such as congenital and acquired hemolytic anemias, abdominal traumas and immunological and metabolic disorders, but it is associated with an immediate and lifelong risk of overwhelming infection. An alternative to conventional splenectomy is partial splenectomy, recommended especially in children younger than 5 years of age. Recommendations for the prevention of overwhelming post-total splenectomy infection include: Pneumococcal, Haemophilus influenzae type B and Meningococcal immunizations, antimicrobial prophylaxis and prompt antibiotic treatment of acute febrile illness; conversely, there is no clear evidence indicating which prevention measures are to be performed in patients undergoing partial splenectomy.

Role of Partial Splenectomy in Gaucher's Disease in Resource Challenged Nations

“…Various studies state one fourth to one-half of normal spleen or remnant spleen equivalent to the size of normal spleen in a pathological spleen like in GD is sufficient to provide functional tissue for defense against overwhelming postsplenectomy sepsis. [ 4 8 9 ]…”