Splenectomy for immune thrombocytopenia : our 11-year experience

 

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dc.contributor.advisor Novitzky, Nicolas en_ZA
dc.contributor.author Antel, Katherine en_ZA
dc.date.accessioned 2015-09-30T13:43:59Z
dc.date.available 2015-09-30T13:43:59Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Antel, K. 2015. Splenectomy for immune thrombocytopenia : our 11-year experience. University of Cape Town. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14134
dc.description.abstract Splenectomy has been practiced for the treatment of ITP for the past few decades. Currently it is utilised when a patient is either dependent or resistant to steroid treatment and the platelet count remains less than 30×109/L. Recently new agents have been added to the armamentarium used to treat ITP, including immune-suppressants such as rituximab and the new thrombopoetin-receptor agonists. This has brought into question the role of surgery for the treatment of ITP, and the need to compare the response and complication rates of splenectomy to these newer agents. Historic studies done on splenectomy for the treatment of ITP have been performed in the setting of low HIV prevalence. There is a relative paucity of data on the response rate in HIV-associated thrombocytopenia to splenectomy and the durability of response to splenectomy is unclear in this patient population. We retrospectively analysed 73 consecutive patients who underwent splenectomy for ITP from 2001 to 2011. The primary objective was to determine the rate of complete response, this was defined as a platelet count greater than 100×109/L at one year post splenectomy. Results were compared between HIV positive and HIV negative patients. The secondary objectives were: to evaluate the intra-operative and post†operative complications and mortality in the HIV positive and HIV negative groups, and to investigate for associations between co-morbidities, pre-operative treatment and response to splenectomy. en_ZA
dc.language.iso eng en_ZA
dc.subject.other Haematology en_ZA
dc.title Splenectomy for immune thrombocytopenia : our 11-year experience en_ZA
dc.type Master Thesis
uct.type.publication Research en_ZA
uct.type.resource Thesis en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Medicine en_ZA
dc.type.qualificationlevel Masters
dc.type.qualificationname MSc en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Antel, K. (2015). <i>Splenectomy for immune thrombocytopenia : our 11-year experience</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/14134 en_ZA
dc.identifier.chicagocitation Antel, Katherine. <i>"Splenectomy for immune thrombocytopenia : our 11-year experience."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2015. http://hdl.handle.net/11427/14134 en_ZA
dc.identifier.vancouvercitation Antel K. Splenectomy for immune thrombocytopenia : our 11-year experience. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/14134 en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Antel, Katherine AB - Splenectomy has been practiced for the treatment of ITP for the past few decades. Currently it is utilised when a patient is either dependent or resistant to steroid treatment and the platelet count remains less than 30×109/L. Recently new agents have been added to the armamentarium used to treat ITP, including immune-suppressants such as rituximab and the new thrombopoetin-receptor agonists. This has brought into question the role of surgery for the treatment of ITP, and the need to compare the response and complication rates of splenectomy to these newer agents. Historic studies done on splenectomy for the treatment of ITP have been performed in the setting of low HIV prevalence. There is a relative paucity of data on the response rate in HIV-associated thrombocytopenia to splenectomy and the durability of response to splenectomy is unclear in this patient population. We retrospectively analysed 73 consecutive patients who underwent splenectomy for ITP from 2001 to 2011. The primary objective was to determine the rate of complete response, this was defined as a platelet count greater than 100×109/L at one year post splenectomy. Results were compared between HIV positive and HIV negative patients. The secondary objectives were: to evaluate the intra-operative and post†operative complications and mortality in the HIV positive and HIV negative groups, and to investigate for associations between co-morbidities, pre-operative treatment and response to splenectomy. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Splenectomy for immune thrombocytopenia : our 11-year experience TI - Splenectomy for immune thrombocytopenia : our 11-year experience UR - http://hdl.handle.net/11427/14134 ER - en_ZA


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