Clinical and surgical outcomes of splenectomy for autoimmune hemolytic anemia.

Abstract

INTRODUCTION:

We investigated short and long-term remission rates after splenectomy in patients with primary and secondary autoimmune hemolytic anemia (AIHA).

METHODS:

All adults who underwent splenectomy for primary or secondary AIHA at a single center (2004-2018) were retrospectively reviewed. Short-term response was determined at 30-day postoperatively and long-term at one year. Complete response was defined as hemoglobin > 10 g/dL without hemolysis, transfusions, or need for additional medical therapy for > 6 months.

RESULTS:

Short-term complete response was attained in 22 of 36 patients (61%), partial response in 3 (8%), no response in 11 (31%). The response rate at 1 year was complete in 14/36 (39%), partial in 14 (39%), and 8 non-response (22%). At last available follow-up (median 33.1 months (IQR 19-59), 16/37 patients had experienced a complete response (43%), 14 partial response (38%), 7 non-response (19%). 80% of partial responders with primary AIHA required maintenance therapy compared to 100% with secondary AIHA.

CONCLUSION:

Splenectomy is associated with short- and long-term improvement in anemia and hemolysis in the majority of patients with AIHA. Immunosuppressants remain important supplemental therapy.

• Authors: Sara Maskal, Raha Al Marzooqi, Aldo Fafaj, Samuel Zolin, Robert Naples, Advait Iyer, Clayton Petro, David Krpata, Ajita Prabhu, Michael Rosen, Steven Rosenblatt
• Journal: Surgical endoscopy (Surg Endosc) Vol. 36 Issue 8 Pg. 5863-5872 (08 2022) ISSN: 1432-2218 [Electronic] Germany
• PMID: 35194660 (Publication Type: Journal Article)
• Copyright: © 2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.

Topics

• Adult
• Anemia, Hemolytic, Autoimmune (complications, drug therapy, surgery)
• Hemolysis
• Humans
• Retrospective Studies
• Splenectomy
• Treatment Outcome