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Post splenectomy related pulmonary hypertension.

Atul V Palkar1, Abhinav Agrawal2, Sameer Verma1

  • 1Department of Pulmonary, Critical Care and Sleep Medicine, North Shore - LIJ Health System, New York, NY 11040, United States.

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|March 8, 2016
PubMed
Summary

Splenectomy increases risks for pulmonary vascular disease and chronic thromboembolic pulmonary hypertension (CTEPH) through complex mechanisms. This review examines the causes and management controversies of post-splenectomy pulmonary vasculopathy.

Keywords:
Chronic thromboembolic pulmonary hypertensionPulmonary hypertensionSplenectomyThalassemiaThrombocytosis

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Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Hematology

Background:

  • Splenectomy, the surgical removal of the spleen, is associated with increased risks of infectious and non-infectious complications.
  • Pulmonary vascular disease, including chronic thromboembolic pulmonary hypertension (CTEPH), is a recognized non-infectious complication following splenectomy.

Purpose of the Study:

  • To review and synthesize current evidence on the pathogenesis of pulmonary vascular disease after splenectomy.
  • To highlight the complexities and uncertainties in the etio-pathogenesis of CTEPH and pulmonary vasculopathy post-splenectomy.
  • To discuss the controversies surrounding the management of these conditions.

Main Methods:

  • Literature review of existing studies and evidence.
  • Analysis of pathophysiologic mechanisms linking splenectomy to pulmonary vascular disease.
  • Synthesis of current understanding and identification of knowledge gaps.

Main Results:

  • Splenectomy predisposes patients to venous thromboembolic events, a key factor in CTEPH development.
  • Complex and not fully elucidated pathophysiologic mechanisms underlie the development of pulmonary vasculopathy post-splenectomy.
  • Evidence suggests a multifactorial etiology involving altered coagulation, inflammation, and endothelial dysfunction.

Conclusions:

  • Pulmonary vascular disease, particularly CTEPH, is a significant concern after splenectomy.
  • Further research is needed to fully understand the etio-pathogenesis and to establish optimal management strategies.
  • Addressing the risks of pulmonary vascular disease is crucial for comprehensive patient care post-splenectomy.