Aspects of immunology and management of post-splenectomy patients

Abstract

The spleen is the largest lymphatic organ in the body and plays an important role in fighting infection. It works to remove micro-organisms and their products circulating within the bloodstream and produce antibodies to enhance the immune response. The spleen is an intraperitoneal organ that performs vital haematological and immunological functions. It maintains both innate and adaptive immunity and protects the body from microbial infections. Splenectomy is associated with an impairment in immunoglobulin production, antibody-mediated clearance, and phagocytosis leading to an increased risk of infection and sepsis. Overwhelming post-splenectomy infection (OPSI) is a syndrome of fulminant sepsis occurring in splenectomized (asplenic) individuals that is associated with high mortality and morbidity. Early identification of the at-risk patient, early blood cultures before antibiotic administration, and sepsis bundles should be utilized in these patients. Prompt management and aggressive treatment can alter the course of disease in the at-risk splenectomized patient. Overwhelming post-splenectomy infection can be prevented through vaccination and patient education.