Outcome following Splenectomy in young Thalassemic patients aged five to eighteen years – a single centre observational study

Abstract

Excessive destruction of abnormal red blood cells and resultant extra-medullary haematopoiesis in be-ta thalassemia major leads to splenomegaly, hypersplenism and increased requirement of blood transfusion, which often necessitate splenectomy.
To evaluate the outcome of splenectomy among patients with beta thalassemia major
A retrospective cross-sectional study was conducted on 26 beta thalassemia major patients, in the age group of 5 to18 years, who underwent elective splenectomy in a tertiary hospital between April, 2016 and May, 2018. Their pre-operative, peri-operative and post-operative follow up data were collected from a prospectively maintained database and analysed.
Out of 26 patients, 8 (30.8%) were female and 18 (69.2%) male. Mean age of our study population was 9.3 years. Mean haemoglobin at the time of admission was 5.76 +/- 0.49 g/dl and mean pre-operative blood transfusion requirement was 31.77 +/- 9.34 units/yr. Median length of post-operative hospital stay was 6 days. Immediate post-operative complications included haemorrhage in 1 (3.8%) patient, sepsis in 1 (3.8%), pulmo-nary complication in 1 (3.8%), wound infection in 2 (7.7%) and death of 2 (7.7%) patients. 19 (73.1%) patients did not encounter any post-operative complication. The mean blood transfusion requirement after splenectomy, as assessed in median follow-up over 26 months, was 13.00+/-7.15 units/yr.
In conclusion, for patients with beta thalassemia major being managed in resource limited setup, splenectomy can be considered as an effective procedure for reducing the blood transfusion requirement and hence, prevent its associated adverse effects.

Keywords

• Thalassemia
• splenectomy
• outcome

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