Post Splenectomy Outcome in β-Thalassemia.
OBJECTIVES
To evaluate changes in annual blood transfusion requirements and complications after splenectomy in patients with β-thalassemia.


METHODS
Forty post-splenectomy β-thalassemic patients aged 8-33 y, receiving regular blood transfusions and chelation therapy were included and non transfusion dependant patients were excluded from this retrospective cross-sectional study. Details about their surgery, transfusion requirements, and platelet levels were recorded on a standard proforma. All patients underwent a B-mode and color-coded duplex sonography of the hepatoportal system during the study period.


RESULTS
The average ferritin level in the year prior to the study was 4432 mcg/L (range 480-12,200 mcg/L). The annual blood transfusion requirement in the first year and 5 y post splenectomy [mean ± SD (138.41 ± 90.38 ml/kg/y); (116 ± 41.44 ml/kg/y)] were significantly different from requirements before splenectomy [(mean ± SD) 294.85 ± 226 ml/kg/y; p value <0.001]. There was a significant rise in platelet counts within 24 h post splenectomy with a mean rise of 4,51,000/mm(3) (p value < 0.001). During the follow up period, infections were noted in 50 % of patients, with malaria (18.75 %) being the most common. Doppler study of the portal system in one case showed portal vein thrombosis.


CONCLUSIONS
A significant sustained fall in annual blood transfusion requirement and a rise in platelet counts occurred post-splenectomy. Increase in annual blood transfusion requirement should be investigated to find the cause.
['Merchant|Rashid H|RH|', 'Shah|Ami R|AR|', 'Ahmad|Javed|J|', 'Karnik|Alka|A|', 'Rai|Nooralam|N|']
D000293:Adolescent D000328:Adult D001803:Blood Transfusion D002648:Child D003430:Cross-Sectional Studies D005260:Female D006801:Humans D007194:India D008297:Male D017063:Outcome Assessment, Health Care D010976:Platelet Count D011168:Portal System D011183:Postoperative Complications D012189:Retrospective Studies D013156:Splenectomy D018616:Ultrasonography, Doppler, Duplex D017086:beta-Thalassemia
Transfusion requirements Complications Post-splenectomy Splenunculi Thalassemia