Blood, 1958, Vol. 13, No. 6, pp. 569-581.
© 1958 American Society of Hematology, Inc.
Role of the Spleen and Effect of Splenectomy
in Sickle Cell Disease
C. C. SPRAGUE 1 and
J. C. S. PATERSON 1
1 Department of Medicine, Tulane University School of Medicine, New Orleans, La.
The survival of sickle cell anemia and sickle-cell/Hb-C erythrocytes was
determined by the radioactive chromium method, both in their parent circulations and in the circulations of compatible normal recipients.
In sickle cell anemia patients with splenomegaly the average erythrocyte
survival time (T
) was found to be 3.7 days. After splenectomy T increased to an average of 11.4 days.
In sickle cell anemia patients without splenomegaly the average T was
found to be 10 days. In five instances an average T of 9.2 days was found,
whereas the average T for the same cells in the circulations of normal
recipients was 4.4 days.
In sickle-cell/Hb-C disease the average T was 15.7 days. Following
splenectomy in two patients, T was unchanged in one and increased in
the second. T was shortened in two of three instances when these cells
were transfused into normal recipients, but the data are insufficient to permit
conclusions to be drawn.
The role of the spleen in hemolysis is discussed briefly and it is concluded
that the hemolytic process in sickle cell anemia is accelerated in the presence
of a spleen. This finding is compatible with the diminution in the severity of
sickle cell anemia frequently recognized in the adult patient whose spleen
has atrophied, and in the child following splenectomy. The validity of the
chromate-tagging method for determining erythrocyte survival is discussed.
Splenectomy was performed in children in whom the erythrocyte survival
was shortened (T less than 6 days).
Submitted on August 7, 1957
Accepted on December 15, 1957
