What is Asplenia?

Asplenia refers to the absence of normal spleen function or of a spleen, an organ located in the upper left side of the abdomen, and that’s crucial in helping our bodies fend off bacterial infections. Asplenia can either be congenital, where a person is born without a spleen or the result of a splenectomy, where the spleen is removed for a particular reason.

Some reasons for undergoing a splenectomy include problems arising from trauma to the spleen or an enlarged spleen. Certain medical conditions such as thalassaemia and hereditary spherocytosis are characterised by an enlarged spleen, which may cause problems such as discomfort, rupture, or pooling and destruction of blood cells in the spleen.

Risks Associated with Asplenia

The spleen serves an important function in our immune systems by helping our bodies fight bacterial infections.

Without a spleen, a child (especially below the age of two) may have a higher risk of developing serious infections, such as overwhelming post-splenectomy infection (OPSI). Even though the risk is small and OPSI is uncommon, it can be very serious, rapidly progressive and even life-threatening if it occurs.

Without a spleen, your child is also at risk of a severe infection, primarily from bacteria such as pneumococcus and meningococcus, which may cause an inflammation of the membrane that covers your child’s brain and spinal cord.

Preventing Infection in Children With Asplenia

Most infections can be avoided or prevented through these measures:

Immunisation for Children with Asplenia

• Ensure that your child is vaccinated against severe bacterial infections caused by pneumococcus, meningococcus and Haemophilus influenzae type B (Hib).
• If your child is scheduled for an elective splenectomy, ensure that he or she is vaccinated against pneumococcus, meningococcus and Hib at least 14 days before surgery. If it is not possible to administer these vaccines before your child undergoes splenectomy, ask your doctor if he or she can be vaccinated 14 days after the operation.
• Your child should also get the pneumococcal, meningococcal and Hib vaccines if he or she is functionally asplenic.
• It is also recommended that all children with asplenia get the influenza vaccination once a year.

Antibiotic Prophylaxis for Children with Asplenia

If your child has undergone splenectomy or is functionally asplenic, your doctor will likely prescribe an antibiotic for the prevention of infection. This antibiotic should be taken daily. The exact duration of the antibiotic treatment will be determined by your doctor.

If your child has just undergone splenectomy or is functionally asplenic and experiencing a fever as well as shivers and dizziness, seek prompt medical attention. Be sure to inform your doctor that your child has just undergone the surgical procedure and is missing a spleen.

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