Removing spleens from people with sickle cell disease after a splenic sequestration compared to blood transfusions to prevent further attacks
We reviewed the evidence to see whether removing all, of part of, the spleen to prevent acute splenic sequestration improved survival and decreased illness in people with sickle cell disease, as compared with regular blood transfusion. This is a 2017 update of a Cochrane Review first published in 2002, and previously updated, most recently in 2015.
In some people with sickle cell disease, red blood cells become trapped and destroyed in the spleen. This damages the spleen, which may become enlarged leading to splenic sequestration crises. These crises consist of abdominal pain, rapid heart rate and other symptoms. Such an attack can be fatal without prompt treatment. All or part of the spleen (splenectomy) is often removed after a person has survived such a crisis to try and prevent another one. This surgery may leave the individual at a higher risk of infection. We looked for trials which compared surgery to blood transfusions.
The evidence is current to: 14 August 2017.
We found no trials to provide reliable evidence about the risks or benefits of splenectomy for people with sickle cell disease after splenic sequestration. There is a need for a trial to assess the benefits and risks of splenectomy compared to transfusion programmes.
There are no trials included in the review and we have not identified any relevant trials up to August 2017. We will continue to run searches to identify any potentially relevant trials; however, we do not plan to update other sections of the review until new trials are published.