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Some Effects of Splenectomy in Thalassaemia Major

Summary. The effect of splenectomy in the thalassaemia syndrome has been investigated by isotopic studies of red cell mass and life span, and plasma volume, before and after splenectomy, in a group of mainly untransfused patients. The plasma volume was grossly expanded in all patients both before and after splenectomy and it decreased moderately in some patients following the operation. The autologous red cell life span increased in all patients after splenectomy, but the red cell mass did not rise proportionately, indicating a substantial decrease in erythropoiesis in some patients. This was accompanied in some cases by a spurt of growth. It is suggested that severe ineffective erythropoiesis in thalassaemia can cause both blood volume expansion as a result of diversion of blood through the bone marrow, and growth retardation, possibly on a competitive basis.