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HealthInfo Canterbury

Splenectomy & hyposplenism

Your spleen is on the left side of your body, just under your rib cage, beside your stomachYour spleen is an organ that helps you develop immunity against infections. It filters foreign substances from your blood and removes worn-out blood cells. It also regulates the blood flow to your liver and stores some blood cells.

Some people have conditions that mean their spleen doesn't work well. These include hyposplenism and splenic atrophy. Some people don't have a spleen.

Splenectomy is the medical name for surgery to remove your spleen. Several medical conditions can make it necessary to remove your spleen. Sometimes, a person needs to have their spleen removed if it's been damaged by an accident or injury.

If your spleen doesn’t work properly or if you have no spleen, you have a higher risk of getting a serious infection such as pneumonia or meningitis.

After having your spleen removed, you're also at risk of an infection known as overwhelming post-splenectomy sepsis.

 

Important

Go to the Emergency Department or after-hours GP at once if you have a high fever (above 38°C) or uncontrolled shaking.

See a doctor within 24 hours if you have a:

Vaccinations

You can get extra vaccinations to reduce your risk of serious infections. You should complete your vaccinations two to four weeks before a planned splenectomy. If you have an unplanned splenectomy, you should get them after you've recovered from the operation. You should also get them if you've been diagnosed with hyposplenism.

Which vaccinations you need depends on what you've had before and what health professionals currently recommend.

The vaccines are free, and you'll usually get them at your GP surgery. You may need to pay a consultation fee.

You'll need boosters of some vaccinations to keep up your immunity (a booster is a repeat of a vaccination that you've had before).

You should have a flu vaccination every year.

Antibiotics

To reduce the risk of an infection, your doctor will talk to you about taking low-dose antibiotics daily for at least two years.

This is usually 250 mg of amoxicillin daily or 250 mg of penicillin twice daily. If you're allergic to those, your doctor will give you a different antibiotic.

If you have trouble remembering your antibiotic or are concerned about side effects, talk to your GP or practice nurse.

You should take an emergency antibiotic if you're concerned about an infection but can’t get to a doctor straight away. This is usually high-dose amoxicillin (3 g followed by 1 g every eight hours).

Ask your pharmacist to put the expiry date on your supply of emergency antibiotics. Regularly check that they haven't expired. Always take a supply of antibiotics if you're away from home.

Animal bites

See a doctor straight away if you're bitten by a dog, cat, another animal or a person. You're more likely to get an infection from a bite. You'll need to get the wound thoroughly washed and dressed and you may need extra antibiotics.

Travelling

Make sure you have all the recommended vaccinations before travelling. You're particularly at risk from malaria so it's best not to travel to areas where malaria is common (such as parts of Africa and Asia).

If you must travel to a place with malaria, be extra strict about taking anti-malarial medications and avoiding mosquito bites.

Make sure you get specialist travel advice. Take a supply of antibiotics with you.

Medical alert bracelet

Wear a medical alert bracelet or pendant, saying that you've had a splenectomy. Search online for medical bracelets NZ to find medical bracelet suppliers. You can also get an application form from your GP or the department that arranged your splenectomy. Your GP or surgeon needs to sign the form.

Splenectomy card

You should carry a splenectomy card with you all the time. You can get one from the Christchurch Hospital Haematology Department. Phone the department on (03) 364‑0384 during working hours to ask for a card.

Written by Haematology Department, Christchurch Hospital. Adapted by HealthInfo clinical advisers. Endorsed by clinical director, Haematology, Canterbury DHB. Last reviewed April 2020.

See also:

Overview of surgery

Splenectomy for children

Page reference: 26765

Review key: HISPA-29575