RESULTS OF SPLENECTOMY FOR IDIOPATHIC THROMBOCYTOPENIC PURPURA - REVIEW OF 72 CASES

Seventy-two patients underwent splenectomy for idiopathic thrombocytop enic purpura between 1979 and 1990. Mean age at splenectomy was 36.4 y ears (range 11-73). Indications for splenectomy were corticodependence in 21 cases and resistance to steroids in 44 cases. Thirty-five patie nts had platelet kinetic studies by Cr-51 alloplatelets; 22 of them ha d splenic sequestration. Hematologic results were evaluated on dischar ge, at 3 months and in the long term (median follow-up 5.4 years). We had no mortality, morbidity was seen in 7% of the cases. None of the p atients suffered from secondary infectious complications. 89% had good results on discharge (> 120 x 10(9)/l), 72.6% at 3 months and 90% on long-term follow-up. Factors associated with good response to splenect omy included a high postoperative platelet count (more than 120 x 10(9 )/l on discharge), younger age at the time of surgery, preoperative co rticodependence and predominantly splenic sequestration.