Splenectomy in thalassaemia major: experience at Madina Maternity and Children's Hospital, Saudi Arabia

Abstract

Eighteen (32%) of 56 children with thalassaemia major, whose ages ranged from 5 to 12 years (mean 8.8), underwent splenectomy at Madina Maternity and Children's Hospital, Saudi Arabia during the period January 1992 to December 1999. This retrospective study was undertaken with the aim of discovering the outcome. The indications for splenectomy were increased transfusion requirements and massive splenomegaly in 17 children and splenic abscess in one. Polyvalent pneumococcal and Haemophilus influenza vaccines were not available and all the children therefore received intramuscular benzathine penicillin prophylaxis prior to surgery and oral penicillin prophylactically afterwards. Post-splenectomy septicaemia did not occur. The mean transfusion requirement reduced from 2 to 4 weeks and the mean pre-transfusion haemoglobin rose from 6 to 9 g/dl. There were no deaths. We conclude that splenectomy can be performed safely in children over 5 years of age with thalassaemia, and that pre- and post-operative penicillin can be given prophylactically in the absence of the recommended vaccines.

Oral health and caries risk profile assessment using the Cariogram in thalassemia patients with or without splenectomy: A cross-sectional study

“…23 With an increased chance of infection, β-thalassemia patients who undergo splenectomy receive antibiotic therapy for life, usually in the form of oral penicillin, with some also receiving a combination of different prophylactic injections pre-operatively. 29,30 This may explain the differences in oral health findings between β-thalassemia patients with and without splenectomy. The effects of penicillin and antibiotics on dental caries in general have been reported since the 1960s.…”

Disposable No Longer: The Spleen Holds a Reservoir of Stem Cells

“…When the distal pancreas is resected for chronic pancreatitis, the rate of insulindependent diabetes increases with splenectomy compared to spleen preservation [9,10]. Splenectomy for children with severe thalassemia also increases the risk of insulin-dependent diabetes [11][12][13]. Even more impressive is the evolving association of traumatic splenectomy and gradual onset of diabetes [14,15].…”