Our Summary

This research paper discusses two conditions related to the spleen: asplenia, which is the absence of the spleen, and hyposplenism, which is a poorly functioning spleen. Both conditions can lead to serious health problems and even death. The spleen plays an important role in our immune system and helps filter our blood. Therefore, when it’s absent or not working properly, the body becomes more susceptible to severe infections, especially from certain types of bacteria.

Asplenia often occurs due to surgical removal of the spleen. This can happen following traumatic injuries or due to certain blood-related cancer conditions. Hyposplenism can be caused by a variety of conditions such as blood disorders, infections, autoimmune diseases, and gastrointestinal disorders. These conditions lead to physical damage to the spleen and a decrease in certain types of immune cells, which cause the associated health problems.

To prevent severe infections after spleen removal, it’s important to identify hyposplenism early and manage asplenia properly. This can be done through vaccinations and antibiotics. Despite having guidelines, there is a need for better vaccination strategies, including more effective vaccines. The paper also suggests the need for screening programs to catch hyposplenism early in high-risk patients and better education for patients.

FAQs

  1. What are asplenia and hyposplenism, and what causes them?
  2. How does the absence or defective function of the spleen increase susceptibility to infections?
  3. What are the recommended strategies for preventing post-splenectomy infections?

Doctor’s Tip

One helpful tip a doctor might tell a patient about splenectomy is to make sure to stay up-to-date on vaccinations, especially those that protect against encapsulated bacteria such as Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b. These vaccines can help prevent serious infections that can occur after splenectomy. It is also important to discuss with your doctor the need for antibiotic prophylaxis to further reduce the risk of infections. Regular follow-up appointments and communication with your healthcare provider are key to ensuring proper management of asplenia or hyposplenism.

Suitable For

Patients who are typically recommended splenectomy include those with traumatic injuries to the spleen, oncohaematological conditions, and certain autoimmune disorders. Additionally, patients with conditions that cause hyposplenism, such as haematological, infectious, autoimmune, and gastrointestinal disorders, may also be recommended splenectomy. These patients are at increased risk of severe and invasive infections, especially those caused by encapsulated bacteria. Early recognition of hyposplenism and proper management of asplenia through vaccination and antibiotic prophylaxis are important to prevent overwhelming post-splenectomy infections. Screening programs for high-risk patients and improvement of patient education are also important in the management of splenectomy patients.

Timeline

Before splenectomy:

  1. Patient may experience symptoms related to the underlying condition necessitating splenectomy, such as trauma or oncohaematological conditions.
  2. Patient may undergo diagnostic tests and consultations with healthcare providers to determine the need for splenectomy.
  3. Patient may receive preoperative counseling and education about the risks and benefits of splenectomy.

After splenectomy:

  1. Patient may experience immediate postoperative recovery and may need to stay in the hospital for monitoring.
  2. Patient may be at increased risk for infections due to the absence of the spleen’s immune function.
  3. Patient may receive vaccinations to prevent infections, particularly against encapsulated bacteria.
  4. Patient may be prescribed antibiotic prophylaxis to prevent overwhelming post-splenectomy infections.
  5. Patient may need to undergo regular follow-up appointments with healthcare providers to monitor for any complications or infections.
  6. Patient may need to adhere to certain lifestyle modifications, such as avoiding certain activities that increase the risk of infection.

What to Ask Your Doctor

  1. Why do I need a splenectomy?
  2. What are the risks and benefits of a splenectomy?
  3. How will my immune system be affected after a splenectomy?
  4. What vaccinations should I receive before and after the surgery?
  5. How can I prevent infections after the splenectomy?
  6. Will I need to take antibiotics long-term after the surgery?
  7. How will my lifestyle need to change after a splenectomy?
  8. What signs or symptoms should I watch for that may indicate a complication from the surgery?
  9. How often should I follow up with you after the splenectomy?
  10. Are there any support groups or resources available for people who have had a splenectomy?

Reference

Authors: Lenti MV, Luu S, Carsetti R, Osier F, Ogwang R, Nnodu OE, Wiedermann U, Spencer J, Locatelli F, Corazza GR, Di Sabatino A. Journal: Nat Rev Dis Primers. 2022 Nov 3;8(1):71. doi: 10.1038/s41572-022-00399-x. PMID: 36329079