Partial splenic embolisation for hypersplenism of thalassaemia major: five year follow up.

Abstract

Six patients with thalassaemia major were treated by partial splenic embolisation as an alternative to splenectomy and followed up for five years. Results were compared with those in a matched control group of seven patients treated by splenectomy.All patients treated by partial splenic embolisation showed a reduction in blood transfusion requirements comparable with those in the controls and which remained unchanged over the five years. Serious infections that commonly occur in patients splenectomised for thalassaemia did not occur after embolisation, presumably owing to preservation of some immune function by the splenic remnant. By contrast with the change in platelet counts seen after splenectomy, platelet counts remained normal after partial splenic embolisation, so reducing the risk of thromboses. On the other hand, pre-existing leucopenia and thrombocytopenia were corrected after embolisation.It is concluded that partial splenic embolisation provides an alternative to splenectomy for thalassaemia major and is equally effective and much safer. IntroductionOverwhelming infections'-3 and pulmonary artery embolism leading to hypoxaemia4 may occur even long after splenectomy for hypersplenism in thalassaemia major. In an attempt to avoid these

Splenectomy for Hematological Diseases: The Qatif Central Hospital Experience

“…40 To obviate this, alternatives to total splenectomy have been tried. [41][42][43][44] We performed partial splenectomy in nine patients with ß-thalassemia major, and three patients with Hb H disease. Two of the three patients with Hb H disease required no more blood transfusions, while the third continued to receive blood transfusions but at a lower frequency.…”

Partial splenectomy in homozygous beta thalassaemia.

“…The diagnosis of thalassaemia major and intermedia was based on transfusion requirements.5 The patients' mean (SD) age was 7-9 (3 7) years (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] years) at the time of the partial splenectomy. Twenty five patients received a low transfusion regimen and five received a high transfusion regimen (table 1).…”

Splenic artery embolization before laparoscopic splenectomy An update

“…The effects of PSE in some cases are temporary, necessitating a repeat procedure. With careful attention to a few technical principles, the incidence of complications after PSE has declined [10,11,14,16,17,20,22]. These principles, referred to as the Spigos technique, include (1) aseptic technique, (2) antibiotic coverage, (3) avoidance of excessive infarction of splenic mass (<60-70%), and (4) effective postembolization analgesia [15].…”