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

Abstract

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.

Splenectomy perspective for non-malignant hematological disorders: A cross-sectional study in the Eastern Province of KSA

“… 24 , 25 Furthermore, preoperative selective blood transfusions in patients with SCD can help minimize postoperative complications. 26 Additionally, most patients showed an overall improvement in their condition after the procedure. Approximately one-third of patients had an average period of 1 year without a need for an additional line of treatment.…”