[Splenectomy in Werlhof disease without thrombocyte substitution. Prospective study of 7 consecutive cases]

As a prophylaxis against the risk of postoperative bleeding platelet mass transfusions or transfusions of whole fresh blood are recommended for splenectomy in chronic idiopathic thrombocytopenic purpura. As the efficacy of this treatment is uncertain, seven consecutive patients with platelet counts of 4000/mm3 (2000-16000) were splenectomized without this prophylaxis. Platelet counts rose to 152500/mm3 (70000--305000) 18 h after operation, in every case the critical lower limit of 50000 was exceeded. Apart from one case of transient fever of undetected origin and one small pleural effusion there were no complications. Even in patients with extremely low platelet counts splenectomy can be performed without platelet mass transfusion.