Work

Hemostasis in children with hemolysis undergoing splenectomy

Year: 2025

Type: article

Abstract: Introduction: Patients with hemolysis are at high risk of thrombosis after splenectomy.However, some patients may also be vulnerable to bleeding.The aim of this study was to estimate the hemostasis system in patients before and after splenectomy.Methodology: Clotting times (APTT,PT), fibrinogen, ATIII, proteins C and S, von Willebrand Factor(vWF:Ag) and D-dimer levels, platelet aggregometry with ADP, collagen, adrenaline, thrombin, and global hemostasis assay (thrombodynamics (TD), thromboelastography (TEG) in two points before and 3-5 days after splenectomy were used to asses the hemostatic state in patients.Twelve children (5 boys and 7 girls, age: 8-17 yrs) with hereditary spherocytosis(HS) and 2 boys (9 and 13 yrs) with autoimmune hemolytic anemia (AIHA) against the background of acute lymphoblastic leukemia(ALL) were enrolled.Results: We divide patients into 2 groups: with and without hemorrhage.Two patients with HS and one patient with AIHA(ALL) had bleeding after surgery.Clotting times and aggregometry were in normal in all patients before and after surgery.PLT levels (257±127 vs 432±221*109/l) were increased in most patients after surgery, so do fibrinogen (2,01±0,69 vs 4,11±1,74g/l, p<0.01) and D-dimer (90±46 vs 1240±2331ng/ml, p<0.01) levels in all patients.We do not reveal the statistically significant changes in PC, ATIII levels, but some patients had lower PS levels.vWF:Ag(161±39 vs 168±56%in 1st group, 113±50 vs 166±88% in 2nd group).

Source: OncoDaily Medical Journal

DOI: 10.69690/odmj-018-0425-487