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


METHODS
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.


CONCLUSIONS
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.
Di Carlo
Isidoro
I
Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania Cannizzaro Hospital, Catania, Italy. idicarlo@unict.it
Primo
Stefano
S
Pulvirenti
Elia
E
Toro
Adriana
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000209:etiology* / Q000517:prevention & control*; D001428:Bacterial Vaccines; D002648:Child; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects*; D055815:Young Adult
D001428:Bacterial Vaccines