in Auto-immune Agnogenic Myeloid Metaplasia Experience with Splenectomy Thrombocytopenia and

SUMMARY In a 5-year period 37 patients with ,auto-immune thrombo­ cytopenic purpura (AITP) and 22 with agnogenic myeloid metaplasia (AMM) underwent splenectomy. In 26 of the patients with AITP (70%) a satisfactory response was obtained, although there was 1 death a year later as a result of infection. In 6 cases (16%) significant post­ operative haemostatic problems were experienced. Seventeen of the patients with AMM (71%) improved as a result ,of the operation, but 3 of them (14%) died in the postoperative period. During the follow-up period a further 4 patients died (18%). Haemorrhagic complica­ tions occurred in 7 patients (32%), of whom 2 died immediately after the operation. Haemostatic screening procedures during this whole period failed to predict ~he risk of postoperative haemor­ rhage, and in neither group did prophylactic platelet infusion significantly reduce haemorrhagic complications.