Post total splenectomy outcome in thalassemia patients

Abstract

Introduction: Splenectomy in thalassemia patient is indicated in the transfusion-dependent patient when hypersplenism increases blood transfusion requirement, prevents adequate control of body iron with chelation therapy and increased risk for infection.Method: This study was retrospective study aims to evaluate the outcome of splenectomy in pediatric thalassemia patients and its related factor. A total 34 thalassemia patient with post total splenectomy patients was included in this study.  Result: Mean age was 20.7 ± 6.5 years old with majority mild malnutrition (61.8%) and the majority of spleen size Schaffner 6-7 (73.5%). The duration between thalassemia diagnosis and total splenectomy was 6-7 years. Statistical analysis showed significant decreased of mean blood transfusion volume from 4691.4 cc per year to 3764.2 cc per year (p = 0.048), decreased mean blood transfusion volume from 219.6 cc per Kg Body Weight (BW) per year to 125.5 cc per Kg BW per year (p<0.001) and decreased of blood transfusion frequency from 12-14 times per year to 6-8 times per year (p<0.001). There is only one case subcutaneous emphysema as complication after splenectomy.Conclusion: Overall, this study showed total splenectomy improve the outcome of thalassemia with hypersplenism with low rate of complication.