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

Brian R. Englum, Jennifer Rothman, Sarah Leonard, Audra Reiter, Courtney Thornburg, Mary Brindle, Nicola Wright, Matthew M. Heeney, C. Jason Smithers, Rebeccah L. Brown, Theodosia Kalfa, Jacob C. Langer, Michaela Cada, Keith T. Oldham, J. Paul Scott, Shawn D.St Peter, Mukta Sharma, Andrew M. Davidoff, Kerri Nottage, Kathryn BernabeDavid B. Wilson, Sanjeev Dutta, Bertil Glader, Shelley E. Crary, Melvin S. Dassinger, Levette Dunbar, Saleem Islam, Manjusha Kumar, Fred Rescorla, Steve Bruch, Andrew Campbell, Mary Austin, Robert Sidonio, Martin L. Blakely, Henry E. Rice

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Purpose 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). Methods 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. Results The analysis included 130 children, with 62.3% (n = 81) undergoing TS. For children with HS, all hematologic measures improved after TS, including a 4.1 g/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. Conclusion 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 smaller changes in their hematologic parameters. These data offer guidance to families and clinicians considering TS or PS.

Original languageEnglish (US)
Pages (from-to)122-127
Number of pages6
JournalJournal of pediatric surgery
Volume51
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Congenital hemolytic anemia
  • Hematologic outcomes
  • Splenectomy
  • Surgical technique

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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