EFFECT OF SPLENECTOMY ON THALASSEMIA

The effects of splenectomy in 18 children with thalassemia (Mediterranean anemia) are evaluated. The subjects varied in age at the time of splenectomy from 1½ to 18½ years and have been followed for 5 months to 28 years since operation. One death occurred at the time of splenectomy, during induction of anesthesia. All patients, even those who later died, benefited initially from splenectomy. They required fewer transfusions and maintained higher hemoglobin levels subsequently for varying periods of time. Of the 18 patients, 7 have died; all but 2 of these developed chronic congestive heart failure late in the course of the disease. Pericarditis was suspected in life and proven at necropsy in three subjects. No definite proof of the relationship of splenectomy to the incidence of penicarditis has been shown. In this small series of patients no significantly increased incidence of severe infection was observed postoperatively.