Splenectomy

Key points

• Following a splenectomy patients are particularly at risk from pneumococcus, Haemophilus, meningococcus and Capnocytophaga canimorsus* infections Vaccination
• TIMING: ideally give vaccines 4–6 WEEKS before an elective splenectomy, and at minimum 2 WEEKS before · after emergency splenectomy for trauma, better antibody responses are seen if vaccination is DELAYED until about 14 days after surgery.
• MENINGOCOCCAL: the old 'meningitis A & C' schedule is SUPERSEDED. All adults and children aged 1 year or over should receive a dose of MenACWY conjugate vaccine IRRESPECTIVE of previous meningococcal vaccination status, and MenB vaccination should be given if not already received.
• HIB: routine Hib vaccination is NO LONGER recommended for older hyposplenic individuals, because Hib is now given in the national infant immunisation schedule and herd protection has made invasive Hib disease very rare in the UK.
• annual influenza vaccination
• PNEUMOCOCCAL: PPV23 from 2 years of age, with BOOSTERS EVERY 5 YEARS — this 5-yearly interval remains current UK practice for asplenia and splenic dysfunction, unlike the routine adult schedule. Antibiotic prophylaxis