Partial embolization of the spleen in patients with thalassemia

The role of partial splenic embolization in alleviating hyperslenism was evaluated in children with thalassemia.

Five children with thalassemia (three with alpha-thalassemia, two with beta-thalassemia) underwent embolization with polyvinyl alcohol particles. In two patients, a second splenic embolization was required.

Of the four patients who were transfusion dependent before embolization, two no longer needed transfusion after embolization and two had decreased requirements. In fifth patient who was not transfusion dependent, the hemoglobin level increased from 7.5 g/dL to 8.2 g/dL (75 to 82 g/L) after embolization. The mean platelet count also increased after embolization in all five patients from 266 x 10(9)/L to 480 x 10(9)/L, and the mean leukocyte count increased in four of the five patients from 7.29 x 10(9)/L to 10.1 x 10(9)/L. In the fifth patient, it was unchanged. In all five patients, there was a decrease in spleen size. All patients experienced abdominal pain, but no other severe complications were noted.

In these five patients, partial splenic embolization was a safe procedure that may be an acceptable alternative to partial or total surgical splenectomy. Transfusion requirements and the spleen size were reduced and the leukocyte and platelet counts increased.