Background: Thalassemia are inherited
blood disorders that can result in the abnormal formation of
hemoglobin .
Splenectomy is indicated in the transfusion-dependent
patient when
hypersplenism increases
blood transfusion requirement and prevents adequate control of body
iron with
chelation therapy . Ninety percent of recipients transfused with
HIV antibody-positive
blood are found to be
HIV infected at follow-up. Prevailing
literature on effects of
splenectomy on
CD4 count suggests that
splenectomy causes an abrupt and prolonged increase in
CD4 cell count . The aims and objectives this is an Institution based prospective
observational study with the aim to observe postoperative outcome in immunocompromised thalassemic
patients following
splenectomy , postoperative outcome following
splenectomy in a
patient with low
CD4 count and to analyze the effect of CD 4 count if any on different
patients in terms of
wound infection ,
chest infection ,
urinary tract infection or
infection at any other site.
Methods: The study included twenty immunocompromised
thalassemia Patients attending in Pediatric
Surgery OPD and admitted to Paediatric
Surgery department of Medical college and
hospital Kolkata with
splenomegaly and
HIV infection for
splenectomy , between January 2015 to December 2016.Simple comparative
analysis of gathered data was used to evaluate postoperative outcome m and the preop and the post op
CD4 count levels of splenectomised thalassaemic
patients .
Results: Most
patients in this study were in the (3-8) years
age group and all are
HIV positive
patients with
thalassemia . In this study author found there was increased
CD4 count after
splenectomy and
postoperative period one
patient developed postoperative
oral candidiasis .
Conclusions: HIV -infected thalassaemic
patients on
ART can now safely undergo major
splenectomy surgery with encouraging results and in
patients with a low
CD4 count , there is no relation of
CD4 count and
splenectomy outcome.