Surgery>>>>>Spleen
Question 6#

The disproportionately high rate of overwhelming postsplenectomy infection (OPSI) in thalassemia patients is thought to be due to an immune deficiency. Which of the following strategies has been shown to reduce mortality?

A. Partial splenectomy
B. Prophylactic antibiotic therapy
C. Delaying splenectomy until after 2 years of age
D. Transfusion to maintain a hemoglobin (HGB) of >9 mg/dL

Correct Answer is A

Comment:

The increase in infectious complications associated with splenectomy in thalassemia patients is thought to be due to a coexisting immune deficiency that is caused by iron overload. Iron overload is associated with both thalassemia as well as the transfusions that accompany treatment for thalassemia. Some investigators have tried partial splenectomy with some success in reducing mortality associated with splenectomy in these patients. In addition, splenectomy should be delayed until the patient is older than 4 years unless absolutely necessary. While transfusion to maintain a hemoglobin (HGB) of >9 mg/dL is part of the treatment for thalassemia it does not reduce infectious complications associated with splenectomy in these patients. There is little evidence supporting efficacy of prophylactic antibiotics in asplenic patients in preventing infectious complications associated with splenectomy.