The role of splenectomy in multimodality treatment of thrombotic thrombocytopenic purpura.

Abstract:

:Current treatment modalities for thrombotic thrombocytopenic purpura (TTP) include plasmapheresis (PP), splenectomy, steroids, dextran, other antiplatelet agents, and vinca alkaloids. Prior to the development of PP and use of multimodality treatment for TTP, mortality rates exceeded 50%. This report reviews 11 patients treated for TTP, demonstrates the successful use of splenectomy as salvage therapy, and defines our indications for splenectomy in the treatment of this disorder. Ten of 11 patients were initially treated with PP; three responded completely and one died of fulminant disease. Six patients had a transient partial response to plasmapheresis and were subsequently treated with splenectomy, steroids, and dextran-70. Initial plasmapheresis resulted in improvement in laboratory values and clinical status in those patients requiring splenectomy. Durable remission (6-48 months) was achieved in 91% of patients with minimal morbidity.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Schneider PA,Rayner AA,Linker CA,Schuman MA,Liu ET,Hohn DC

doi

10.1097/00000658-198509000-00007

subject

Has Abstract

pub_date

1985-09-01 00:00:00

pages

318-22

issue

3

eissn

0003-4932

issn

1528-1140

journal_volume

202

pub_type

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