Splenectomy and complications: A complex different disease background, yet a common denominator exists

Splenectomy is a major element in the treatment of hemoglobinopathies, such as transfusion dependent thalassaemia (TDT), non-transfusion dependent thalassaemia (NTDT), sickle cell anaemia (SCA), other red cell disorders like spherocytosis or other haematological diseases of autoimmune origin. A recent, long-year study describes a large series of splenectomized patients in Italy. The authors of this systematic work found that the probability of a post-splenectomy complication depends on the underlying disease and not on the age of the patient at splenectomy. Thus, splenectomy should be performed, when clinically indicated, regardless of the patient's age. The following commentary provides a critical evaluation of the results of the published study, discussing also the novelty, quality and limitations of this important work, in the perspective of current knowledge. Commentary on: Casale et al. Underlying disease is the main risk factor in post-splenectomy complication risk: Data from a national database. Br J Haematol 2025; 206:1811-1821.