Post Splenectomy Outcome in β-Thalassemia.

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.

journal_name

Indian J Pediatr

authors

Merchant RH,Shah AR,Ahmad J,Karnik A,Rai N

doi

10.1007/s12098-015-1792-5

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

1097-100

issue

12

eissn

0019-5456

issn

0973-7693

pii

10.1007/s12098-015-1792-5

journal_volume

82

pub_type

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