Should all splenectomised patients be vaccinated to avoid OPSI? Revisiting an old concept: an Italian retrospective monocentric study.

ABSTRACT

BACKGROUND/AIMS: [corrected] The aims of this study were to evaluate the incidence of overwhelming postsplenectomy infection (OPSI), the usefulness of vaccination in preventing OPSI, and whether affected patients had received the current best practice preventive measures. METHODOLOGY: The patients, observed from June 1991 to May 2005, were reviewed retrospectively. Gender, age, causes of splenectomy, vaccinations and complications were studied. RESULTS: 225 patients (178 males, 47 females) underwent splenectomy, and of these, 79 patients (35.1%) were considered for the present study. Seven patients (8.8%) were informed about the risks of infection and received pneumococcal polysaccharide vaccine after splenectomy. Sixty-eight patients (86.7%) receive influenza vaccine every year. One of the patients that did not receive immunoprophylaxis had OPSI (incidence 1.26%) 1 year after splenectomy. CONCLUSION: Vaccination seems to prevent OPSI. Because of low incidence of OPSI, however, prospective randomised studies in patients without risk factors are needed to evaluate the usefulness of immunoprophylaxis.