Comparison of Need of Transfusion and Adverse Effects before and after Splenectomy in Beta-Thalassemic Patients

Thalassemia is the most common hereditary disease. Hypersplenism and splenomegaly occur in thalassemic patients due to the hereditary defect in globin chain of hemoglobin molecule and extramedullary hematopoiesis that results in more destruction in red blood cells. Therefore, these patients need to splenectomy to reduce recurrent blood transfusion and its complications. The aim of this study was to compare the need of transfusion and adverse effects before and after splenectomy in beta-thalassemic patients referred to Yahyanejad hospital (Babol, Iran). This cross sectional study was performed on 63 splenectomized thalassemic patients who referred to Yahyanejad hospital in Babol during 8 years. Demographic information, kind of thalassemia, clinical symptoms, spleen size, number of transfusions, and platelet and red blood cell count were evaluated before and after splenectomy in these patients. In this study, 37 (58.7%) out of the 63 cases had thalassemia major and 26 cases (41.2%) had thalassemia intermedia. Eleven, 21, 9 and 17 cases had abdominal pain, anorexia, fever and gall stone, respectively. These patients had undergone cholecystectomy simultaneously. Six cases had portal vein thrombosis and 5 patients had infectious complications in long time post splenectomy. Mean operation time and mean hospital stay was 2.70±0.73 and 6.26±2.14. Mean white blood cell count, hemoglobin level, platelets and red blood cells (RBCs) count were raised significantly after splenectomy (p<0.05). Mean transfusion was reduced (p<0.05). We found 26 hepatitis, 14 haemosiderosis, 1 cirrhosis and 6 portal vein thrombosis (PVT) cases on pathology report of liver biopsy. Splenectomy reduces blood transfusion times and its complications in thalassemic patients, therefore splenectomy recommends in patients with indications for surgery.