From the Guidelines
Yes, a person who has undergone a splenectomy is considered immunocompromised, though in a specific way. After splenectomy, patients have an increased risk of infection, particularly from encapsulated bacteria like Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, as noted in the study by 1. This occurs because the spleen plays a crucial role in filtering blood and removing pathogens, as well as producing antibodies against these encapsulated organisms. The risk of overwhelming post-splenectomy infection (OPSI) is highest in the first two years after surgery but remains lifelong.
Key Considerations
- Patients who have had a splenectomy should receive specific vaccinations including pneumococcal, meningococcal, Haemophilus influenzae type b, and annual influenza vaccines, as recommended by 1.
- Some patients may also need prophylactic antibiotics, particularly children and those with additional immune system issues, as suggested by 1 and 1.
- Patients should seek immediate medical attention for any fever or signs of infection and should inform all healthcare providers about their splenectomy status.
- The immune compromise from splenectomy is partial rather than complete, affecting primarily the response to certain bacterial infections rather than causing broad immunosuppression.
Vaccination and Prophylaxis
- Vaccinations against Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis should be given at least 2 weeks before splenectomy, if possible, as stated in 1 and 1.
- Annual influenza vaccination is recommended for all patients over 6 months of age, as noted in 1.
- Prophylactic antibiotics may be necessary in certain cases, such as in children or those with additional immune system issues, and patients should be educated on the use of emergency standby antibiotics, as suggested by 1.
Conclusion is not allowed, so the answer just ends here.
From the Research
Definition of Immunocompromised
A person is considered immunocompromised if they have a weakened immune system, making them more susceptible to infections and diseases.
Splenectomy and Immunocompromised Status
- A splenectomy, or the removal of the spleen, can lead to an increased risk of infections, particularly those caused by encapsulated bacteria such as Streptococcus pneumoniae 2, 3, 4.
- Studies have shown that individuals who have undergone a splenectomy are at a higher risk of developing severe infections, including pneumonia and bacteremia 3, 4.
- The risk of infection is highest in the first few years after splenectomy, especially in older adults and those with underlying hematologic disorders 3, 4.
- While some studies suggest that splenectomized patients may not be at an increased risk of COVID-19 infection, they may be at a higher risk of hospitalization or death if they do contract the virus 5.
- Additionally, splenectomized patients with hematological diseases may have a poor response to pneumococcal polysaccharide vaccination, making them more susceptible to pneumococcal infections 6.
Key Points
- Splenectomy can lead to an increased risk of infections, particularly those caused by encapsulated bacteria.
- The risk of infection is highest in the first few years after splenectomy, especially in older adults and those with underlying hematologic disorders.
- Splenectomized patients may be at a higher risk of hospitalization or death if they contract COVID-19.
- Splenectomized patients with hematological diseases may have a poor response to pneumococcal polysaccharide vaccination.
Implications
- Individuals who have undergone a splenectomy should be considered immunocompromised and take precautions to prevent infections, such as receiving recommended vaccinations and taking antibiotics as prescribed.
- Healthcare providers should be aware of the increased risk of infections in splenectomized patients and monitor them closely for signs of infection.