Partial splenectomy in sickle cell disease

Abstract Introduction Total splenectomy in sickle cell disease is related to a high risk of fulminant sepsis and increased incidence of other events, which have not been reported in patients with partial splenectomy. In this study we examined the patients with sickle cell disease and partial splenectomy and compared the clinical and laboratory results with non-splenectomised patients. Materials and methods We studied 54 patients with sickle cell disease who underwent partial splenectomy in childhood from 1986 until 2011 at the Institute of Hematology and Immunology. They were compared with 54 non-splenectomised patients selected by random sampling with similar characteristics. Results Partial splenectomy was performed at a mean age of 4.1 years, with a higher frequency in homozygous haemoglobin S (70.4%), and the most common cause was recurrent splenic sequestration crisis. The most common postoperative complications were fever of unknown origin (14.8%) and acute chest syndrome (11.1%). After splenectomy there was a significant increase in leukocytes, neutrophils, and platelets, the latter two parameters remained significantly elevated when compared with non-splenectomised patients. There was no difference in the incidence of clinical events, except hepatic sequestration, which was more common in splenectomised patients. Conclusion Partial splenectomy was a safe procedure in patients with sickle cell disease. There were no differences in the clinical picture in children splenectomised and non-splenectomised except the greater frequency of hepatic sequestration crisis in the first group.