Splenectomy for Beta Thalassemia Major Among Transfusion Dependent Patients, its Effectiveness and Complications

Abstract

Objectives: To evaluate the effectiveness and complications of splenectomy among thalassemia major patients who need repeated blood transfusion.

Study design: retrospective descriptive

Place and duration of study: Conducted at paediatric and neonatal surgery department of tertiary care hospital from Jan 2020 to Jan 2024.

Material and methods: 43 patients with  ?-thalassemia having meadian age 13 years (9 -17 years) who were taking repeated blood transfusion from thalassemia units were included in study. Ultrasonography was performed in all patients to find any accessary spleen, changes in the need for annual blood transfusion, platelets levels changes pre and post splenectomy, quality of life and complications after splenectomy like haemorrhage intra-abdominal, and from wound site, respiratory tract infections were recorded.

Results: Post splenectomy blood requirement was decreased significantly. a rise in serum platelet level was noted after splenectomy. Serum ferritin level decreased significantly. The quality of life as described by the parents was much improved. 3 patients showed incision site bleeding which managed by diathermy coagulation and blood / platelet transfusion. 3 patients presented with fever after 3 months of splenectomy and managed by paediatric medicine department.

Conclusion: After splenectomy, patients experienced a significant and sustained reduction in annual blood transfusion needs, accompanied by a rise in platelet counts and improved quality of life. However, any subsequent increase in transfusion requirements warrants thorough investigation to determine the underlying cause.

Keywords: Thalassemia; Post-splenectomy Complications; Blood transfusion