AI Article Synopsis
- The study aimed to assess how splenectomy affects blood transfusion needs and complications in β-thalassemia patients.
- Significant changes in transfusion requirements were observed, with a decrease after splenectomy (from 294.85 ml/kg/y before to 138.41 ml/kg/y after one year).
- While platelet counts increased significantly post-surgery, 50% of patients faced infections, particularly malaria, highlighting potential complications following the procedure.
Article Abstract
Objectives: To evaluate changes in annual blood transfusion requirements and complications after splenectomy in patients with β-thalassemia.
Methods: Forty post-splenectomy β-thalassemic patients aged 8-33 y, receiving regular blood transfusions and chelation therapy were included and non transfusion dependant patients were excluded from this retrospective cross-sectional study. Details about their surgery, transfusion requirements, and platelet levels were recorded on a standard proforma. All patients underwent a B-mode and color-coded duplex sonography of the hepatoportal system during the study period.
Results: The average ferritin level in the year prior to the study was 4432 mcg/L (range 480-12,200 mcg/L). The annual blood transfusion requirement in the first year and 5 y post splenectomy [mean ± SD (138.41 ± 90.38 ml/kg/y); (116 ± 41.44 ml/kg/y)] were significantly different from requirements before splenectomy [(mean ± SD) 294.85 ± 226 ml/kg/y; p value <0.001]. There was a significant rise in platelet counts within 24 h post splenectomy with a mean rise of 4,51,000/mm(3) (p value < 0.001). During the follow up period, infections were noted in 50 % of patients, with malaria (18.75 %) being the most common. Doppler study of the portal system in one case showed portal vein thrombosis.
Conclusions: A significant sustained fall in annual blood transfusion requirement and a rise in platelet counts occurred post-splenectomy. Increase in annual blood transfusion requirement should be investigated to find the cause.
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| http://dx.doi.org/10.1007/s12098-015-1792-5 | DOI Listing |
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