Should all splenectomised patients be vaccinated to avoid OPSI? Revisiting an old concept: an Italian retrospective monocentric study
Di Carlo, I.; Primo, S.; Pulvirenti, E.; Toro, A.
Hepato-Gastroenterology 55(82-83): 308-310
2008
ISSN/ISBN: 0172-6390 PMID: 18613354 Document Number: 3557
Backgound/Aims: The aims of this study were to evaluate the incidence of overwhelming post-splenectomy infection (OPSI), the usefulness of vaccination in preventing OPSI, and whether affected patients had received the current best practice preventive measures.Methodology: The patients, observed from June 1991 to May 2005, were reviewed retrospectively. Gender, age, causes of splenectomy, vaccinations and complications were studied.Results: 225 patients (178 males, 47 females) underwent splenectomy, and of these, 79 patients (35.1%) were considered for the present study. Seven patients (8.8%) were informed about the risks of infection and received pneumococcal polysaccharide vaccine after splenectomy. Sixty-eight patients (86.7%) receive influenza vaccine every year. One of the patients that did not receive immunoprophylaxis had OPSI (incidence 1.26%) 1 year after splenectomy.Conclusion: Vaccination seems to prevent OPSI. Because of low incidence of OPSI, however, prospective randomised studies in patients without risk factors are needed to evaluate the usefulness of immunoprophylaxis.
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