SPLENECTOMY

NAVEEN IS ADVISED SPLENECTOMY.  THE DETAILS I HAVE BRIEFED ABOVE.  NAVEEN IS A NEW MEMBER.  PL GUIDE

Hello Naveen,

It would be extremely difficult to give opinions without knowing the history of the person.

Are you a Thal(Major) or Thal(Intermedia)? How big is your spleen? How frequent is your transfusions now?

Also, listen to your doctor. he might have the best view of you. There have been posts on this site related to splenectomy, which might give you some idea

Naveen,

here is some more information, I found out which might be helpful to you

Some information is from:- http://www.thalassaemiaindia.org

Spleen
Spleen is a soft, purplish organ about the size of one’s fist. It is located just below the diaphragm on left side safely hidden under the ribs.
It is not palpable while examining the abdomen. A normal spleen contains only 20-30 ml of red blood cells, a very large spleen may contain 1 litre or more.

When Splenectomy?
Increase of annual blood requirement by 50% or more over initial requirement.
Presence of massive splenomegaly.
When size of spleen is 6-8 cm or upto the naval, splenectomy should be considered seriously.

Why Splenectomy?
Patients with Thalassemia Intermedia & Major invariably develop splenomegaly due to ineffective production of blood cells in spleen and iron deposition.
This hypersplenism causes increased destruction of red cells resulting in increased blood requirement, increased iron load & enhanced risk of transfusion transmitted infections.
In addition to destroying the older red blood cells, the overactive spleen also destroys some white blood cells(WBCs), platelets and young red blood cells, further worsening the anemia.
The red blood cells circulating in the system of the patients with thal have an abnormal shape because they lack normal Hb molecules, and often become trapped in the spleen - which adds to the size of the spleen.

Also, the spleen may also attempt to counteract the body's anemia by producing red blood cells itself (also called extramedullary erythropoeisis), which further contributes to the spleens enlargement

Advantage of Splenectomy
Spleen removal might reduce your transfusion requirement
A non-splenectomised patient requires approximately 180 ml of red blood cells/kg/year while a splenectomised patient requires about 133 ml/kg/year

Risks
Splenectomy significantly increases the risk of serious infection and preferably be postponed to after 6th year of age
Patient should be immunized against Pneumococcal, Meningococcal A & C & Haemophilus influenza B (HiB), 4-6 weeks prior to operation.

After Splenectomy
Prolonged Penicillin prophylaxis (250 mg bd) or injection Benzethine Penicillin 6-12 lacs every 3 weeks should be prescribed post Splenectomy.
Post splenectomy fevers/upper respiratory infections/any infection should be managed promptly.
Broad spectrum antibodies including amoxycillin/co-trimoxazole should be started at home.
Patient should be hospitalised if fever doesnot subside within 48 hours.
Aspirin 50-100mg/day may be advised if platelet count exceeds 8,00,000/mm3