Our Summary

This research paper studied the impact of vaccination on infection rates in adults who had their spleen removed (splenectomy) in Olmsted County, Minnesota from 1965 to 2011. They found that 724 patients had undergone a splenectomy, with nearly half being women and the average age being 55. About 62% of these patients had been vaccinated against pneumonia, H influenza, and meningitis.

They found that 36% of these patients developed an infection after their surgery, with the most common type of infection being sepsis (a serious condition caused by the body’s response to an infection). The three most common infections were pneumonia, bloodstream infections, and urinary tract infections.

They also found that patients who were not vaccinated got infections faster than those who were vaccinated (1.5 years vs 3.3 years). The risk of infection was highest in patients who did not get all the necessary vaccines. Not being fully vaccinated was linked to getting an infection faster and having a higher rate of bloodstream infections 5 years after surgery.

The risk of infection went down as the vaccination protocols improved for all conditions except cancer. The researchers concluded that adults who have had their spleen removed should continue to get booster vaccines.

FAQs

  1. What is the overall vaccination rate for adults who underwent splenectomy?
  2. What is the risk of infection for patients who did not receive complete vaccination after splenectomy?
  3. What is the median time to infection for non-vaccinated patients compared to vaccinated patients after splenectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about splenectomy is to ensure they receive complete vaccination, including pneumococcal, H influenza, and meningococcal vaccines. This can reduce the risk of post-splenectomy infections and improve long-term outcomes. Patients should also follow up with their healthcare provider for booster vaccines as recommended.

Suitable For

Patients who are typically recommended splenectomy include those with conditions such as hereditary spherocytosis, thalassemia, autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura (ITP), Hodgkin lymphoma, non-Hodgkin lymphoma, and certain types of leukemia. Additionally, splenectomy may be recommended for patients with traumatic injuries to the spleen or certain types of splenic tumors.

Timeline

Before splenectomy:

  1. Patient is diagnosed with a condition that requires splenectomy, such as trauma, immune thrombocytopenic purpura, or hereditary spherocytosis.
  2. Patient undergoes preoperative evaluations and tests to assess their overall health and suitability for surgery.
  3. Patient may receive vaccinations to prevent post-splenectomy infections, such as pneumococcal, H influenza, and meningococcal vaccines.

After splenectomy:

  1. Patient undergoes splenectomy surgery to remove the spleen.
  2. Patient is monitored closely in the hospital for any postoperative complications.
  3. Patient may receive antibiotics to prevent infections.
  4. Patient is educated on the increased risk of infections post-splenectomy and the importance of vaccination.
  5. Patient may experience post-splenectomy infections, with the most common being pneumonia, bloodstream infections, and urinary tract infections.
  6. Patients who did not receive complete vaccination have a higher risk of post-splenectomy infections and a quicker time to infection compared to those who were vaccinated.
  7. Patients are advised to continue receiving booster vaccines to reduce the risk of infections in the long term.

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 a splenectomy?
  2. How will my immune system be affected after the spleen is removed?
  3. Will I need to receive vaccinations after the splenectomy to prevent infections?
  4. How often will I need to receive booster vaccines?
  5. What signs and symptoms should I watch for that may indicate an infection after the splenectomy?
  6. How can I reduce my risk of developing infections after the splenectomy?
  7. Will I need to take any additional medications or precautions to prevent infections?
  8. How often should I follow up with my doctor after the splenectomy?
  9. Are there any lifestyle changes I should make to protect my health after the splenectomy?
  10. Are there any specific activities or environments I should avoid to reduce my risk of infection?

Reference

Authors: Hernandez MC, Khasawneh M, Contreras-Peraza N, Lohse C, Stephens D, Kim BD, Zielinski MD. Journal: Surgery. 2019 Oct;166(4):556-563. doi: 10.1016/j.surg.2019.04.046. Epub 2019 Aug 1. PMID: 31378483