Partial splenectomy for children with congenital hemolytic anemia and massive splenomegaly

Partial splenectomy but not total splenectomy preserves immunoglobulin M memory B cells in mice

“…This preliminary animal study suggests that partial splenectomy might preserve the analogous cell population of peripheral blood IgM memory B cells in humans. Given the current interest in maintaining immune function in children who require splenic resection for hematologic disease or hypersplenism [12][13][14][15][16], preservation of memory IgM B cells would support use of partial splenectomy. Further studies in animal models and human trials will better define immunologic benefits of partial splenectomy.…”

Splenectomy and partial splenectomy improve hematopoietic stem cell engraftment in hypersplenic mice

“…Because of concerns of increased infections risks after total splenectomy in children [13][14][15][16], interest has developed in the use of partial splenectomy to augment HSC transplantation. Initial clinical evidence suggests that partial splenectomy in children with congenital hemolytic anemias may preserve enough splenic tissue to maintain some splenic function, as assessed by the clearance of erythrocytes containing Howell-Jolly bodies, maintenance of serum IgM and IgG levels, and radionuclide uptake by liver-spleen scan [17][18][19][20][21][22][23][24][25][26]. Our initial experience with 5 children who underwent pretransplantation partial splenectomy compares favorably with those who underwent total splenectomy (n = 10), with both procedures resulting in a shorter time to HSC engraftment compared with age-matched nonsplenectomized children (n = 497) [7].…”

Partial splenectomy prevents splenic sequestration crises in sickle cell disease

“…Partial splenectomy has also been performed for children with massive splenomegaly and congenital hemolytic anemias [10]. The risk of overwhelming infection and sepsis after total splenectomy is theoretically reduced because the remaining spleen is functional and offers immune competency [3].…”