Platelet safety range before splenectomy for hypersplenism : based on 244 cases of splenectomy in hepatolenticular degeneration patients

Abstract

Background and study aims : To investigate the safety and efficacy of splenectomy for hepatolenticular degeneration (HLD) patients with PLT less than 20 × 109/L. Patients and methods : A total of 244 HLD patients with hyper-splenism underwent splenectomy. According to the preopera-tive PLT values, the patients were divided into three groups : group A of 53 patients with PLT < 20 × 109/L ; group B of 92 patients with 20 × 109/L ≤ PLT ≤ 30 × 109/L ; group C of 99 patients with PLT > 30 × 109/L. General information including : blood cell counts, liver function , coagulation function 1 day before sugery and 1, 7, 14 days after surgery ; intraoperative blood loss ; operation time ; vital signs at the beginning, at 60 minutes and the end of the operation. Pressure and blood oxygen ; postoperative drainage ; postoperative complications and mortality. Results : Blood cell counts, liver function, and coagulation func-tion were improved after splenectomy in three groups (P<0.05) ; there was no significant difference in blood loss, operation time, vital signs during the operation, postoperative drainage, postoper-ative complications and mortality between three groups (P>0.05). Conclusion : For HLD patients with hypersplenism, it is safe and effective to conduct splenectomy under PLT < 20 × 109/L.

Clinical observation and risk assessment after splenectomy in hepatolenticular degeneration patients associated with hypersplenism

“…In the beginning, we performed splenectomy in the pursuit to relieve hypersplenism, normalize blood cells level, and meet the requirement of lifelong anti-copper treatment. We have previously reported our experience and results in this regard (23)(24)(25)(26)(27)(28). The expanded sample size of HLD patients involved in this work further confirmed that splenectomy can achieve the desired anti-copper effect and improve the blood cells level.…”

“…The incidence of HLD in China is around 6/100,000, and our department is the largest HLD treatment center in China (23)(24)(25)(26)(27)(28). In the beginning, we performed splenectomy in the pursuit to relieve hypersplenism, normalize blood cells level, and meet the requirement of lifelong anti-copper treatment.…”