Survivorship: Health Concerns After Splenectomy

What is the spleen?

The spleen is an organ in the upper part of your abdomen (belly) that works like a filter, removing bacteria and dead red blood cells from your bloodstream. In some cancers, the spleen may be removed or treated with radiation, causing it to not work as it should. This condition is called “asplenia.”

What happens after a splenectomy?

Removal of the spleen (or radiation to the spleen) puts you at higher risk for infections caused by certain types of bacteria. Streptococcus pneumoniae and Haemophilus influenzae type b are the most common infections after a splenectomy. An infection can quickly turn to sepsis, which is a life-threatening reaction in your body. Sepsis can lead to death if not treated quickly with antibiotics. Some experts think survivors with asplenia should have antibiotics on hand to start taking at the first sign of infection, even before being seen by their healthcare team. Talk with your provider to see if they want you to do this.

If you had a splenectomy you should:

• Report a fever (temperature higher than 100.4°F [38°C]) or any sign of infection (sore throat, cough, burning with urination, ear pain, rash, or shortness of breath) to your healthcare team right away, or to go to an emergency room.
• Tell any healthcare provider caring for you that you do not have a working spleen.
• Wear a medic-alert bracelet stating that you do not have a functioning spleen ("asplenia").
• Get an annual influenza (flu) vaccine, as well as the pneumococcal and Hepatitis B vaccines.
• Get the meningococcal and H. influenzae type b vaccines (this is not the same as the annual flu vaccine).
• If bitten by a dog, cat, or rodent, you will need to take antibiotics to prevent getting an infection with Capnocytophaga canimorsus bacteria.
• If you travel to or are living in an area with malaria, take medication to prevent infection with malaria and use mosquito repellent.
• If you are traveling to or living near Cape Cod or Nantucket Island in Massachusetts, Southern New England, and the Hudson Valley in New York, you may be more likely to have issues from an infection called Babesia caused by deer ticks. If you have been bitten by a tick, call your healthcare provider as soon as possible because this species of tick may give you Lyme disease.

Further Reading

The Centers for Disease Control: What Vaccines are Recommended for You. 

Patient.co.uk: Preventing Infection after Splenectomy or if you do not have a Working Spleen. 

UpToDate Patient Information: Preventing severe infection after splenectomy.