Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia

Journal of Pediatric Surgery
Brian R EnglumSplenectomy in Congenital Hemolytic Anemia Consortium

Abstract

The purpose of this study was to define the hematologic response to total splenectomy (TS) or partial splenectomy (PS) in children with hereditary spherocytosis (HS) or sickle cell disease (SCD). The Splenectomy in Congenital Hemolytic Anemia (SICHA) consortium registry collected hematologic outcomes of children with CHA undergoing TS or PS to 1 year after surgery. Using random effects mixed modeling, we evaluated the association of operative type with change in hemoglobin, reticulocyte counts, and bilirubin. We also compared laparoscopic to open splenectomy. The analysis included 130 children, with 62.3% (n=81) undergoing TS. For children with HS, all hematologic measures improved after TS, including a 4.1g/dl increase in hemoglobin. Hematologic parameters also improved after PS, although the response was less robust (hemoglobin increase 2.4 g/dl, p<0.001). For children with SCD, there was no change in hemoglobin. Laparoscopy was not associated with differences in hematologic outcomes compared to open. TS and laparoscopy were associated with shorter length of stay. Children with HS have an excellent hematologic response after TS or PS, although the hematologic response is more robust following TS. Children with SCD have smalle...Continue Reading

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Citations

Jul 10, 2016·Pediatric Blood & Cancer·Henry E Rice
Dec 17, 2016·British Journal of Haematology·Lydia H PeckerLori Luchtman-Jones
May 12, 2020·Pediatric Blood & Cancer·Jennifer A RothmanTheodosia A Kalfa
Jul 24, 2020·Blood·Mary Risinger, Theodosia A Kalfa
May 31, 2016·American Journal of Hematology·Emmanuel BalandyaJulie Makani
Jul 25, 2019·Frontiers in Physiology·Satheesh ChonatTheodosia A Kalfa
Apr 4, 2017·Indian Pediatrics·Anirban DasReena Das
Jul 28, 2019·Pediatric Hematology and Oncology·Serena I TripodiVenée N Tubman
Jan 21, 2021·Journal of Pediatric Surgery·Niloufar HafeziFrederick J Rescorla

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