Prophylactic Splenectomy and Hyposplenism in Spaceflight

Area of Science:

• Space Medicine
• Surgical Oncology
• Radiation Biology

Background:

• Debate exists regarding prophylactic splenectomy for astronauts on long-duration spaceflights.
• Potential spleen risks in space include radiation and trauma, but splenectomy itself carries considerable risks.

Approach:

• A systematic review analyzed 5 decades of data on splenectomy risks and spleen irradiation risks during spaceflight.
• Forty-one articles were reviewed to assess the safety and efficacy of splenectomy in the context of space travel.

Key Points:

• Splenectomy risks include significant intraoperative and postoperative mortality, thromboembolic events, and portal vein thrombosis.
• Delayed risks encompass overwhelming postsplenectomy infection (OPSI) and an increased relative risk of malignancy.
• Space radiation doses are unlikely to cause hematologic malignancy but may increase hyposplenism risk.

Conclusions:

• Prophylactic splenectomy benefits for astronaut cancer protection do not outweigh the associated risks.
• Vaccinations against encapsulated organisms are recommended for long-duration spaceflight to mitigate hyposplenism risk.