Our Summary

This research paper examines the importance of vaccination for patients who have had their spleen removed. Without a spleen, patients are at a lifelong risk of severe infections, which can be fatal. The study reviews English-language articles published between 1990 and 2019 on this subject from various medical databases. The findings indicate that despite the lack of clinical trials, vaccinations seem to effectively reduce the incidence of severe infections in these patients. However, the research also shows that vaccination rates are inconsistent and often substandard, and there are no specific guidelines on who should administer the vaccines or when they should be given. The paper suggests that surgeons should be primarily responsible for ensuring patients are properly vaccinated, both before and after the operation to remove the spleen. It concludes that more research is needed to establish the best timing for vaccination and the need for booster doses.

FAQs

  1. Why is vaccination important for patients who have had their spleen removed?
  2. What does the research suggest about the effectiveness of vaccinations in reducing severe infections in splenectomy patients?
  3. According to the research, who should be responsible for ensuring patients are properly vaccinated before and after a splenectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about splenectomy is to make sure they stay up to date on their vaccinations. Since the spleen plays a crucial role in the body’s immune system, patients who have had their spleen removed are at a higher risk of infections. Vaccinations can help protect against certain diseases and reduce the risk of severe infections. It is important for patients to discuss their vaccination schedule with their healthcare provider and ensure they receive all recommended vaccines, including any necessary booster shots.

Suitable For

Patients who have had their spleen removed, also known as asplenic or hyposplenic patients, are typically recommended splenectomy. This includes individuals with conditions such as hereditary spherocytosis, autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, and traumatic injuries to the spleen.

Additionally, patients with certain types of cancer, such as lymphoma or leukemia, may also require splenectomy as part of their treatment. Patients with conditions that cause enlargement of the spleen, such as cirrhosis or certain infections, may also benefit from splenectomy.

Overall, the decision to recommend splenectomy is based on the specific medical condition of the patient and their individual circumstances. It is important for patients to discuss the risks and benefits of splenectomy with their healthcare provider to determine if it is the best course of action for their health.

Timeline

Before splenectomy:

  • Patient may have a medical condition that requires removal of the spleen
  • Consultation with a surgeon to discuss the risks and benefits of the procedure
  • Pre-operative testing and preparation
  • Surgery to remove the spleen

After splenectomy:

  • Patient is at an increased risk of severe infections due to the lack of a spleen
  • Vaccination against encapsulated bacteria such as pneumococcus, meningococcus, and Haemophilus influenzae type b is recommended
  • Monitoring for any signs of infection and seeking prompt medical attention if necessary
  • Follow-up appointments with the surgeon and primary care physician to assess overall health and the effectiveness of vaccinations.

What to Ask Your Doctor

Some questions a patient should ask their doctor about splenectomy include:

  1. What are the potential risks and complications of splenectomy?
  2. How will my immune system be affected after having my spleen removed?
  3. What vaccinations should I receive after splenectomy to prevent infections?
  4. When should I receive these vaccinations and how often do I need booster doses?
  5. What symptoms should I watch for that may indicate an infection, and what should I do if I experience them?
  6. Are there any lifestyle changes I should make to reduce my risk of infections after splenectomy?
  7. How often should I follow up with my doctor after the surgery to monitor my health and immune function?
  8. Are there any specific precautions I should take when traveling or in crowded places to protect myself from infections?
  9. Are there any support groups or resources available for patients who have undergone splenectomy?
  10. What role will my surgeon play in ensuring I receive the necessary vaccinations and ongoing care related to my splenectomy?

Reference

Authors: Casciani F, Trudeau MT, Vollmer CM Jr. Journal: JAMA Surg. 2020 Nov 1;155(11):1068-1077. doi: 10.1001/jamasurg.2020.1463. PMID: 32936229