Super-selective Partial Splenic Embolization for Hereditary Spherocytosis in Children: A Single-Center retrospective Study

Hereditary spherocytosis is the most common cause of hemolytic anemia due to defects in the blood cell membrane. Partial splenic embolization (PSE) might significantly improve the effects of hemolysis in HS patients while preserving partial splenic function. However, due to the poor controllability of the scope of interventional embolization, PSE in pediatric HS had not been widely studied and applied. The present study is the first to propose that optimized PSE procedure to treat pediatric HS patients, which named super-selective partial splenic embolization (SPSE). We investigated the feasibility and effectiveness of SPSE. This study was conducted by retrospectively reviewing clinical data from HS patients treated by surgical treatments who were diagnosed at children’s hospital of Chongqing medical university from January 2015 to December 2019. Patients were divided into two groups according to treatment preference: SPSE (16 patients) group and total splenectomy (41 patients) group. The data were analyzed such as preoperative and postoperative leukocytes, hemoglobin, platelets, bilirubin, immunological indicators, and postoperative complications. The success rate of two groups were 100%. The improvement of hemolysis in patients after SPSE was not different from that after total splenectomy, and the effect can be maintained for a long time. The average hemoglobin value increased significantly from 6.97g/dL before SPSE to 12.2g/dL after SPSE (P=0.000). SPSE was performed without any serious complications. SPSE is a safe and effective treatment for moderate or severe HS in children.