Our Summary

The research paper discusses a study conducted on seven patients who underwent kidney transplants from donors with different blood types and had their spleen removed to reduce the B cell pool. This procedure was found to potentially increase the likelihood of developing a cytomegalovirus (CMV) infection much later after the transplant, even around 10 years later. CMV can cause serious health issues such as retinitis, an eye condition, and colitis, an inflammatory bowel disease. The findings suggest that doctors should be aware of this risk when performing spleen removals during kidney transplants, particularly for patients receiving kidneys from donors with different blood types.

FAQs

  1. What is the potential risk associated with spleen removal during kidney transplants?
  2. How does spleen removal increase the likelihood of developing a cytomegalovirus (CMV) infection?
  3. What health issues can a CMV infection cause after a kidney transplant?

Doctor’s Tip

One helpful tip a doctor might tell a patient about splenectomy is to be vigilant about monitoring for infections, especially in the years following the procedure. The spleen plays a crucial role in fighting off infections, so patients who have undergone splenectomy may be more susceptible to certain infections. It is important for patients to promptly seek medical attention if they develop symptoms of an infection, such as fever, chills, or persistent cough. Patients should also speak with their healthcare provider about receiving vaccinations to help prevent certain infections, such as pneumonia or meningitis, that they may be at higher risk for post-splenectomy. Regular follow-up appointments with a healthcare provider can help ensure that any potential complications are detected and treated early.

Suitable For

Patients who may be recommended for splenectomy include those with certain hematologic disorders such as hereditary spherocytosis, thalassemia, and immune thrombocytopenic purpura. Splenectomy may also be considered for patients with certain types of cancer, such as Hodgkin’s lymphoma or chronic lymphocytic leukemia, as well as for patients with certain types of infections, such as recurrent infections of the spleen. Additionally, splenectomy may be recommended for patients with traumatic injuries to the spleen that cannot be managed conservatively.

Timeline

Before splenectomy:

  1. Patient undergoes evaluation by healthcare provider to determine if a splenectomy is necessary.
  2. Patient is informed about the risks and benefits of the procedure.
  3. Preoperative tests and screenings are conducted to assess the patient’s overall health and determine if they are a suitable candidate for surgery.
  4. Patient may be placed on medications or undergo other treatments to prepare for the surgery.

After splenectomy:

  1. Patient undergoes the splenectomy procedure, which involves the surgical removal of the spleen.
  2. Recovery period post-surgery, during which the patient may experience pain, fatigue, and other side effects.
  3. Patient may be prescribed antibiotics and vaccinations to prevent infections, as the spleen plays a key role in the immune system.
  4. Follow-up appointments with healthcare provider to monitor the patient’s recovery and overall health.
  5. Patient may need to make lifestyle changes, such as avoiding certain activities or foods that could increase the risk of infection.
  6. Long-term monitoring and management of potential complications, such as increased risk of infections or blood clotting disorders.

What to Ask Your Doctor

  1. What are the potential risks and benefits of having a splenectomy?
  2. How will removing my spleen affect my immune system and overall health?
  3. Will I be more susceptible to certain infections or health conditions after having my spleen removed?
  4. Are there any alternative treatment options to a splenectomy that I should consider?
  5. How long is the recovery period after a splenectomy and what should I expect during this time?
  6. Will I need any special vaccinations or medications after the procedure to prevent infections?
  7. How often will I need to follow up with you after the splenectomy to monitor my health?
  8. Will I need to make any lifestyle changes or adjustments after having my spleen removed?
  9. Are there any long-term risks or complications associated with having a splenectomy?
  10. How will having a splenectomy affect my ability to receive future medical treatments or surgeries?

Reference

Authors: Iwai T, Uchida J, Kosoku A, Kabei K, Nishide S, Naganuma T, Maeda K, Yoshikawa Y, Kumada N, Takemoto Y, Nakatani T. Journal: Urol Int. 2020;104(7-8):651-656. doi: 10.1159/000504862. Epub 2020 May 19. PMID: 32428910