Splenectomy in a thalassemia and pancytopenia child: A difficult prospect

Splenectomy is viewed as a treatment option that alleviates transfusion requirements, reduces the risk of hypersplenism-related complications, and improves the overall quality of life in transfusion-dependent thalassemia children. However, these patients frequently develop cardiomyopathy or heart failure, restrictive lung dysfunction, pulmonary hypertension, and hypercoagulability due to recurrent blood transfusions, iron overload, and chelating therapy. It is crucial to consider individual patient factors and potential risks and benefits in addition to a multidisciplinary pre-operative approach and a carefully planned strategy. Here, we discuss the perioperative management of a 7-year-old girl with transfusion-dependent beta thalassemia major, hepatitis C, and severe thrombocytopenia.