@article{cad54ff054574d5a90ef6bc29f21f679,
title = "Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia",
abstract = "Purpose The purpose of this study was to define the hematologic response to total splenectomy (TS) or partial splenectomy (PS) in children with hereditary spherocytosis (HS) or sickle cell disease (SCD). Methods The Splenectomy in Congenital Hemolytic Anemia (SICHA) consortium registry collected hematologic outcomes of children with CHA undergoing TS or PS to 1 year after surgery. Using random effects mixed modeling, we evaluated the association of operative type with change in hemoglobin, reticulocyte counts, and bilirubin. We also compared laparoscopic to open splenectomy. Results The analysis included 130 children, with 62.3% (n = 81) undergoing TS. For children with HS, all hematologic measures improved after TS, including a 4.1 g/dl increase in hemoglobin. Hematologic parameters also improved after PS, although the response was less robust (hemoglobin increase 2.4 g/dl, p < 0.001). For children with SCD, there was no change in hemoglobin. Laparoscopy was not associated with differences in hematologic outcomes compared to open. TS and laparoscopy were associated with shorter length of stay. Conclusion Children with HS have an excellent hematologic response after TS or PS, although the hematologic response is more robust following TS. Children with SCD have smaller changes in their hematologic parameters. These data offer guidance to families and clinicians considering TS or PS.",
keywords = "Congenital hemolytic anemia, Hematologic outcomes, Splenectomy, Surgical technique",
author = "Englum, {Brian R.} and Jennifer Rothman and Sarah Leonard and Audra Reiter and Courtney Thornburg and Mary Brindle and Nicola Wright and Heeney, {Matthew M.} and {Jason Smithers}, C. and Brown, {Rebeccah L.} and Theodosia Kalfa and Langer, {Jacob C.} and Michaela Cada and Oldham, {Keith T.} and Scott, {J. Paul} and Peter, {Shawn D.St} and Mukta Sharma and Davidoff, {Andrew M.} and Kerri Nottage and Kathryn Bernabe and Wilson, {David B.} and Sanjeev Dutta and Bertil Glader and Crary, {Shelley E.} and Dassinger, {Melvin S.} and Levette Dunbar and Saleem Islam and Manjusha Kumar and Fred Rescorla and Steve Bruch and Andrew Campbell and Mary Austin and Robert Sidonio and Blakely, {Martin L.} and Rice, {Henry E.}",
note = "Funding Information: In addition to the authors, the SICHA consortium collaborators include: Brittany Herzberg, Jeffrey M. Ferranti, Sofia Mouttalib, Meredith Nahm, Rachel Richesson, Denise C. Snyder. We thank Terri Ainsworth, Mark Bettger, Ceci Chamorro, Phyllis Kennel, Justin Levens, Joan Wilson and the Duke Office of Clinical Research (DOCR) their assistance. The DOCR is supported by the Duke School of Medicine, made possible through CTSA Grant Number UL1TR001117 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not represent the official view of NCATS or NIH. This work was supported in part by the Duke University Office of Clinical Research and the Duke School of Medicine, made possible through Clinical and Translational Science Awards Grant Number UL1TR001117 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. Publisher Copyright: {\textcopyright} 2016 Elsevier Inc.",
year = "2016",
month = jan,
day = "1",
doi = "10.1016/j.jpedsurg.2015.10.028",
language = "English",
volume = "51",
pages = "122--127",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
number = "1",
}