Open splenectomy in Jamaican children with sickle cell disease

Duncan, N. D.; Tennant, I; Crawford-Sykes, A; Barnett, A H; Scarlett, M; Dundas, SE; Badal, G; Chin, Bum Sik

doi:10.1590/s0043-31442006000100009

Cited by 7 publications

(11 citation statements)

References 15 publications

(26 reference statements)

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“…10,14,24 In Jamaica, splenectomy and cholecystectomy cases were not pre-operatively transfused when Hb levels were at steady state or above. 9,22,25 An overall morbidity of 19/150 cases (12.7%) is reported with ACS accounting for 11/150 (7.3%) .This morbidity rate after splenectomy is similar to other reports traced in the world literature. 11,12,16,18…”

Section: Discussionsupporting

confidence: 81%

Splenectomy in Jamaican children with sickle cell disease: Outcome of selective blood transfusion

Steele

Simms

et al. 2020

Trop Doct

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We reviewed the post-operative morbidity and mortality of open splenectomy undertaken in conjunction with selective blood transfusion in Jamaican children with sickle cell disease. Data were collected on 150 splenectomies performed between November 1994 and October 2017. Selective blood transfusion involved raising haemoglobin levels to approximately 100 g/L in patients with admission haemoglobin ≥10 g/L below steady state. There was no mortality. Mean post-operative stay was 3.2 days with a median of three days. Total morbidity was 19/150 cases (12.7%), with acute chest syndrome accounting for 11/19 (57.9%). Among the non-transfused, acute chest syndrome occurred in 10/117 cases (8.5%), while among transfused, acute chest syndrome occurred in 1/33 cases (2.9%). We recommend this selective blood transfusion protocol for patients with sickle cell disease to surgeons who undertake splenectomies in settings where blood bank reserves are perennially low.

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Section: Discussionsupporting

confidence: 81%

Splenectomy in Jamaican children with sickle cell disease: Outcome of selective blood transfusion

Steele

Simms

et al. 2020

Trop Doct

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“…This surgical procedure is aimed at reducing deaths from recurrent episodes of acute splenic sequestration; it sometimes improves nutritional status and hematological levels related to chronic hypersplenism. According to the literature, the prevalence of acute splenic sequestration is estimated at around 7.5–30% 18, 19. Although not all patients investigated in this study were referred for surgery, the rate of splenectomy in this study was within the expected range.…”

Section: Discussionmentioning

confidence: 47%

Clinical and laboratory profile of patients with sickle cell anemia

Sant’Ana

Araujo

Pimenta

et al. 2017

Revista Brasileira de Hematologia e Hemoterapia

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ObjectiveThis study aimed to describe and analyze clinical and laboratory characteristics of patients with sickle cell anemia treated at the Hemominas Foundation, in Divinópolis, Brazil. Furthermore, this study aimed to compare the clinical and laboratory outcomes of the group of patients treated with hydroxyurea with those patients that were not treated with hydroxyurea.MethodsClinical and laboratorial data were obtained by analyzing medical records of patients with sickle cell anemia.ResultsData from the medical records of 50 patients were analyzed. Most of the patients were female (56%), aged between 20 and 29 years old. Infections, transfusions, cholecystectomy, splenectomy and systemic arterial hypertension were the most common clinical adverse events of the patients. The most frequent cause of hospitalization was painful crisis. The majority of patients had reduced values of hemoglobin and hematocrit (8.55 ± 1.33 g/dL and 25.7 ± 4.4%, respectively) and increased fetal hemoglobin levels (12 ± 7%). None of the clinical variables was statistically significant on comparing the two groups of patients. Among hematological variables only hemoglobin and hematocrit levels were statistically different between patients treated with hydroxyurea and untreated patients (p-value = 0.005 and p-value = 0.001, respectively).ConclusionSickle cell anemia requires treatment and follow-up by a multiprofessional team. A current therapeutic option is hydroxyurea. This drug reduces complications and improves laboratorial parameters of patients. In this study, the use of the drug increased the hemoglobin and hematocrit levels of patients.

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“…Hemoglobin F is known to have an inhibitory effect upon the process of red blood cells sickling by interfering with the formation of hemoglobin S polymers. It has been further observed that patients having an hemoglobin F level higher than 20% are more likely to have milder sickling manifestations [1,[5][6][7][8][9][10][11][12][13]. This may explain the milder form of ACS in our population group.…”

Section: Discussionmentioning

confidence: 83%