A Study Comparing Blood Transfusion Requirement and Frequency of Blood Transfusion In Splenectomized and Non Splenectomized Children with Beta Thalassemia Major - Our Institutional Experience

Abstract

Introduction : Beta thalassemia major is an autosomal recessive blood disorder. Thalassemia refers to a group of genetic disorders of globin chain production in which there is an imbalance between the ????-globin and ????-globin chain production. ????-Thalassemia syndromes result from a decrease in ????-globin chains, which results in a relative excess of ????-globin chains. Material and Methods : Sample size : 45. Duration of Study: June 2016- June 2018. Children from 5 to 15 years of age who are diagnosed case of Beta thalassemia Major with blood requirement more than 200 ml/kg/year. The patients were divided into 2 
groups: 5 to 10 years and 11 to 15 years. History and complete physical examination with haematological workup were done in all cases. Pre-transfusion
haemoglobin of all 45 patients was noted. The risks and benefits of splenectomy were explained, 20 patients were selected for splenectomy. Result : From the Age group of 5 to 10 years there were Total 22 patients out of which 11 underwent splenectomy. The normal haemoglobin level in the children of this age group is 12.5 gm/dl on an average. The average haemoglobin level in non-splenectomised patients were 7 gm/dl. On the other hand the average
haemoglobin level in a splenectomised patient was 9gm/dl, 6 months after splenectomy. The annual blood requirement of all splenectomised and non - splenectomised patients was compared. In non splenectomised patients the annual requirement was 260 ml/kg/year while in splenectomised patients it was 210 ml/kg/year. Conclusion : The mean haemoglobin levels were on a higher side in splectomized patients as compared to their pre-operative levels as well as compared to non-splenectomized patients. The blood requirement significantly reduced in splenectomized patients to 210 ml/kg/year.