Conditions for which elective splenectomy may be appropriate therapy

Possibly indicated

Cancer surgery*
Felty syndrome
Hereditary spherocytosis
Immune thrombocytopenia (ITP)
Pyruvate kinase (PK) deficiency
Splenic abscess
Splenic marginal zone lymphoma
Splenic vein thrombosis with bleeding gastric varices
Splenomegaly (massive or symptomatic)
Transfusion-dependent thalassemia
Warm autoimmune hemolytic anemia (AIHA)

Rarely indicated

ABO or HLA desensitization for kidney transplant
Chronic lymphocytic leukemia (CLL)
Hairy cell leukemia
Hodgkin lymphoma
Primary myelofibrosis
Splenic infarction
Splenic sequestration crisis in sickle cell disease
Thrombocytopenia in hepatic cirrhosis
Thrombotic thrombocytopenic purpura (TTP)

Generally contraindicated

Autoimmune lymphoproliferative syndrome (ALPS)
Cold agglutinin disease
Gaucher disease
Hereditary stomatocytosis
Hereditary xerocytosis
Paroxysmal cold hemoglobinuria

This is meant as general guidance and should not take the place of the judgment of the clinician(s) caring for the individual patient. Splenectomy is almost always reserved for patients for whom other less invasive therapies are ineffective. Refer to UpToDate topics on specific conditions for the supporting evidence and alternative therapies to splenectomy.

HLA: human leukocyte antigen.

* Examples include debulking for ovarian cancer; left hemicolectomy for colon cancer; pancreatectomy for pancreatic cancer; or gastric or renal cell cancer surgery when the spleen is adhered to the involved organ.

Graphic 121576 Version 5.0

خرید پکیج

Conditions for which elective splenectomy may be appropriate therapy