Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia

Brian R. Englum; Jennifer Rothman; Sarah Leonard; Audra Reiter; Courtney Thornburg; Mary Brindle; Nicola Wright; Matthew M. Heeney; C. Jason Smithers; Rebeccah L. Brown; Theodosia Kalfa; Jacob C. Langer; Michaela Cada; Keith T. Oldham; J. Paul Scott; Shawn D.St Peter; Mukta Sharma; Andrew M. Davidoff; Kerri Nottage; Kathryn Bernabe; David B. Wilson; Sanjeev Dutta; Bertil Glader; Shelley E. Crary; Melvin S. Dassinger; Levette Dunbar; Saleem Islam; Manjusha Kumar; Fred Rescorla; Steve Bruch; Andrew Campbell; Mary Austin; Robert Sidonio; Martin L. Blakely; Henry E. Rice

doi:10.1016/j.jpedsurg.2015.10.028

Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia

Brian R. Englum, Jennifer Rothman, Sarah Leonard, Audra Reiter, Courtney Thornburg, Mary Brindle, Nicola Wright, Matthew M. Heeney, C. Jason Smithers, Rebeccah L. Brown, Theodosia Kalfa, Jacob C. Langer, Michaela Cada, Keith T. Oldham, J. Paul Scott, Shawn D.St Peter, Mukta Sharma, Andrew M. Davidoff, Kerri Nottage, Kathryn BernabeDavid B. Wilson, Sanjeev Dutta, Bertil Glader, Shelley E. Crary, Melvin S. Dassinger, Levette Dunbar, Saleem Islam, Manjusha Kumar, Fred Rescorla, Steve Bruch, Andrew Campbell, Mary Austin, Robert Sidonio, Martin L. Blakely, Henry E. Rice

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21 Scopus citations

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.

Original language	English (US)
Pages (from-to)	122-127
Number of pages	6
Journal	Journal of pediatric surgery
Volume	51
Issue number	1
DOIs	https://doi.org/10.1016/j.jpedsurg.2015.10.028
State	Published - Jan 1 2016
Externally published	Yes

Keywords

Congenital hemolytic anemia
Hematologic outcomes
Splenectomy
Surgical technique

ASJC Scopus subject areas

Surgery
Pediatrics, Perinatology, and Child Health

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10.1016/j.jpedsurg.2015.10.028

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Englum, B. R., Rothman, J., Leonard, S., Reiter, A., Thornburg, C., Brindle, M., Wright, N., Heeney, M. M., Jason Smithers, C., Brown, R. L., Kalfa, T., Langer, J. C., Cada, M., Oldham, K. T., Scott, J. P., Peter, S. D. S., Sharma, M., Davidoff, A. M., Nottage, K., ... Rice, H. E. (2016). Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia. Journal of pediatric surgery, 51(1), 122-127. https://doi.org/10.1016/j.jpedsurg.2015.10.028

Englum, BR, Rothman, J, Leonard, S, Reiter, A, Thornburg, C, Brindle, M, Wright, N, Heeney, MM, Jason Smithers, C, Brown, RL, Kalfa, T, Langer, JC, Cada, M, Oldham, KT, Scott, JP, Peter, SDS, Sharma, M, Davidoff, AM, Nottage, K, Bernabe, K, Wilson, DB, Dutta, S, Glader, B, Crary, SE, Dassinger, MS, Dunbar, L, Islam, S, Kumar, M, Rescorla, F, Bruch, S, Campbell, A, Austin, M, Sidonio, R, Blakely, ML & Rice, HE 2016, 'Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia', Journal of pediatric surgery, vol. 51, no. 1, pp. 122-127. https://doi.org/10.1016/j.jpedsurg.2015.10.028

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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.}",

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year = "2016",

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doi = "10.1016/j.jpedsurg.2015.10.028",

language = "English (US)",

volume = "51",

pages = "122--127",

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TY - JOUR

T1 - Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia

AU - Englum, Brian R.

AU - Rothman, Jennifer

AU - Leonard, Sarah

AU - Reiter, Audra

AU - Thornburg, Courtney

AU - Brindle, Mary

AU - Wright, Nicola

AU - Heeney, Matthew M.

AU - Jason Smithers, C.

AU - Brown, Rebeccah L.

AU - Kalfa, Theodosia

AU - Langer, Jacob C.

AU - Cada, Michaela

AU - Oldham, Keith T.

AU - Scott, J. Paul

AU - Peter, Shawn D.St

AU - Sharma, Mukta

AU - Davidoff, Andrew M.

AU - Nottage, Kerri

AU - Bernabe, Kathryn

AU - Wilson, David B.

AU - Dutta, Sanjeev

AU - Glader, Bertil

AU - Crary, Shelley E.

AU - Dassinger, Melvin S.

AU - Dunbar, Levette

AU - Islam, Saleem

AU - Kumar, Manjusha

AU - Rescorla, Fred

AU - Bruch, Steve

AU - Campbell, Andrew

AU - Austin, Mary

AU - Sidonio, Robert

AU - Blakely, Martin L.

AU - Rice, Henry E.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - 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.

AB - 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.

KW - Congenital hemolytic anemia

KW - Hematologic outcomes

KW - Splenectomy

KW - Surgical technique

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SN - 0022-3468

VL - 51

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JO - Journal of pediatric surgery

JF - Journal of pediatric surgery

IS - 1

ER -

Hematologic outcomes after total splenectomy and partial splenectomy for congenital hemolytic anemia

Abstract

Keywords

ASJC Scopus subject areas

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