Extreme Thrombocytosis after Pediatric Pancreatectomy with Islet Autotransplantation Is Unique Compared to Other Postsplenectomy States
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In brief
In brief
Retrospective study of 112 pediatric splenectomy patients reveals that those undergoing pancreatectomy with islet autotransplantation develop extreme thrombocytosis (platelets ≥1000 K/μL) at significantly higher rates (90%) compared to other splenectomy indications (15.7%). IAT patients demonstrate faster platelet rise and higher peak counts, suggesting unique hematologic response requiring distinct monitoring protocols.
Written by the GCMD Library team from the article.
Background
Hematologic trends after pancreatectomy with islet autotransplantation (IAT), which involves splenectomy, have been rarely studied. Reactive thrombocytosis (RT, platelets ≥500 K/μL) often occurs postoperatively, similar to other postsplenectomy states, but the degree of similarities and true incidence are unknown.
Study design
A single-site, retrospective, observational cohort study of patients who underwent total splenectomy between 2010 and 2018 was performed. Thrombocytosis incidence and pharmacologic management strategies were evaluated, including cohort-based analyses for IAT versus other splenectomy indications.
Results
Analyses included 112 patients overall, 42 of whom underwent IAT. RT occurred frequently (93.8%) despite most patients having normal preoperative platelet counts. IAT patients had significantly higher peak platelet counts compared to non-IAT patients and the rate of platelet rise for IAT patients was significantly faster. IAT was uniquely predictive of developing extreme thrombocytosis (ExT, platelets ≥1000 K/μL, 90% vs. 15.7%, risk ratio 4.11, P