Removing spleens from people with sickle cell disease after a splenic sequestration compared to treating them with blood transfusions to prevent further attacks

In some people with sickle cell disease, red blood cells become trapped and destroyed in the spleen. This damages the spleen, which may become enlarged leading to splenic sequestration crises. These crises consist of abdominal pain, rapid heart rate and other symptoms. Such an attack can be fatal without prompt treatment. All or part of the spleen (splenectomy) is often removed after a person has survived such a crisis to try and prevent another one. This surgery may leave the individual at a higher risk of infection. We looked for trials which compared surgery to blood transfusions. We found no trials to provide reliable evidence about the risks or benefits of splenectomy for people with sickle cell disease after splenic sequestration. There is a need for a trial to assess the benefits and risks of splenectomy compared to transfusion programmes.