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Changes in cerebral blood flow in children with sickle cell disease after splenectomy
Abdul Hafeez Siddiqui1, Peter B Soh
1University of South Alabama, Children's and Women's Hospital, Department of Pediatrics, Division of Hematology/Oncology , Alabama , USA.
Insights
Splenectomy in children with sickle cell disease may temporarily increase cerebral blood flow velocity. Continued monitoring for stroke risk is crucial post-surgery due to these changes.
Area of Science:
- Pediatric Hematology
- Neurology
- Vascular Medicine
Background:
- Sickle cell disease (SCD) is a genetic disorder affecting red blood cells.
- Splenectomy is a procedure sometimes performed in children with SCD.
- Cerebral blood flow (CBF) changes and stroke risk are significant concerns in pediatric SCD.
Purpose of the Study:
- To evaluate the impact of splenectomy on cerebral blood flow velocity in children with sickle cell disease.
- To assess the long-term need for chronic blood transfusions post-splenectomy.
- To understand the implications for stroke risk monitoring after splenectomy.
Main Methods:
- Retrospective chart review of 40 pediatric patients with sickle cell disease who underwent splenectomy.
- Analysis of cerebral blood flow velocity measurements before and at 2 and 5 years after splenectomy.
- Evaluation of platelet counts and transfusion history.
Main Results:
- Mean time-average maximum velocity (TAMV) increased from 129 cm/sec pre-splenectomy to 157 cm/sec at 2 years and decreased to 137 cm/sec at 5 years.
- A persistent and statistically significant elevation in platelet count was observed post-splenectomy.
- Transient increase in mean cerebral blood flow velocity was noted after splenectomy.
Conclusions:
- Splenectomy in children with sickle cell disease may lead to transient elevations in cerebral blood flow velocity.
- Elevated platelet counts persist after splenectomy in this population.
- Continued close monitoring and stroke risk screening are recommended post-splenectomy for these children.
Abstract:
The study assessed changes in cerebral blood flow and need for chronic blood transfusions in sickle cell disease children after splenectomy. A retrospective chart review of 40 children splenectomized between 1999 and 2014 was performed. The mean time-average maximum velocity before splenectomy was 129 cm/sec; which increased to 157 cm/sec and then decreased to 137 cm/sec, 2 and 5 years postsplenectomy, respectively. There was a persistent and statistically significant elevation in platelet count noted after splenectomy. The mean cerebral blood flow velocity seemed to increase transiently after splenectomy. Close monitoring and screening for stroke risk should be continued postsplenectomy.
