Journal of Blood Disorders & Transfusion

Splenectomy for hematology disorder

2^nd International Conference on Hematology & Blood Disorders

September 29-October 01, 2014 DoubleTree by Hilton Baltimore-BWI Airport, USA

Ajayi Oluwatosin Adesola

Posters: J Blood Disorders Transf

Abstract:

Asplenectomy is the surgical removal of the spleen, a small, hand-sized organ located in front of the left kidney and behind the stomach. In ITP, the antibody-coated platelets are often removed from circulation by the spleen. Theoretically, if the spleen is removed, the platelets will remain in the blood stream. The spleen can also be the site of antibody production. Therefore removing the spleen may reduce the amount of anti-platelet antibodies in addition to removing the antibody-coated platelets. Although the spleen is often the major site of antibody-coated platelet destruction, platelets may also be removed from circulation by the liver, by a combination of the spleen and liver, or within the blood stream. Therefore, splenectomies are not always successful in raising the platelet count and may fail over time, prompting a return of low platelets. Splenectomies have been used to treat ITP since 1913. About 10% to 15% of people have no meaningful response to the operation. The published success rates are about 66%, although the measurement criteria for success and the duration of follow-up are not standardized in the studies. There are two types of splenectomies: Laparoscopic where the spleen is removed through a few small holes in the abdomen and open, requiring a large incision. The laparoscopic splenectomy is preferred, when possible, since the healing time is reduced, it has the same rate of success as an open splenectomy, and there are fewer complications. While a splenectomy may raise the platelet count, it does not eliminate ITP since the antibody-coated platelets remain in circulation. In pregnancy, these antibody-coated platelets may cross the placenta and have the potential for reducing the platelet count of the newborn. Doctors vaccinate those about to have a splenectomy with polyvalent pneumococcal, meningococcal C conjugate, and H influenzae b (Hib) vaccines. A small percent of the splenectomized ITP population develops an accessory (extra) spleen. Occasionally a second surgery is required to remove the accessory spleen if the patient has relapsed following a successful first surgery. Other conditions in which splenectomy is required or might be required are Primary cancers of the spleen, hereditary spherocytosis, Sickle cell anemia, trauma, abscesses, rupture of the splenic artery, hereditary elliptocytosis, hypersplenism, Thalassemia, and blood clot in the spleen's blood vessels. Previous response to corticosteroids (Prednisone), IVIg, or other treatments are not very good predictors of splenectomy success. Now researchers in the UK, France, and Spain feel that an indium screening test has some value in predicting whether a splenectomy will successfully raise your platelet counts. The test determines whether your spleen, liver or a combination of both is responsible for your platelet destruction. The immediate complication rate from surgery is about 10%, although estimates vary. The fatality rate from the surgery is about one percent for an open splenectomy and much less than that for a laproscopic procedure. Splenectomized patients have a more difficult time recovering from pneumonia, meningitis, Hib flu, sepsis, hospital-based infections, malaria and other parasitic diseases, babesiosis (a tick-borne disease) and gram-negative bacterial diseases from animal bites. People who have had a splenectomy have more microparticles in their blood, giving them an increased risk of dementia and heart attacks from blood clots. They are also more prone to blood vessel complications, in other words called overwhelming post-splenectomy infections, or OPSI

Biography :

Ajayi Oluwatosin Adesola completed his studies from Ifeoluwa Model College Iyin, Ekiti-State, Nigeria at the age of 16, in 2006. In 2007, he went for a pre-degree program at the University of Ilorin, Nigeria and later attained his first professional MBBS in 2010 at Igbinedion University, Okada, Benin City, Nigeria. He is presently attending All Saint Medical University, Saint Vincent and the Grenadines, (Caribbean) in his third year (8th semester) of clinical training.