Long term follow‐up after splenectomy performed for immune thrombocytopenic purpura (ITP)

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Abstract
Splenectomy is the only treatment of ITP known to have “curative” effects in a substantial fraction of patients. However, the true long‐term outcome is uncertain and controversial because published series have not adjusted for the duration of follow‐up. This IRB‐approved retrospective study included all patients with ITP who underwent splenectomy between 1988‐1993 at three major medical centers and required a minimum postoperative 5‐year follow‐up. Complete response (CR) was defined as all postsplenectomy platelet counts >150 × 109/L without treatment; partial response (PR) as platelet counts ≥50 × 109/L without treatment; and failure as platelet counts 150 × 109/L for 4–8.5 years before relapsing; no clear plateau was attained in the remission curve. There was no operative mortality. Ten patients (18%) reported minor postoperative bleeding episodes. No life‐threatening infections, significant heart disease, or pulmonary hypertension developed after splenectomy in the 434 patient‐years of follow‐up. This study helps to define the long‐term results of splenectomy for ITP. Am. J. Hematol. 72:94–98, 2003.