Refractory therapy in adults.

Mode of Action
Removes 80% of Fc receptors.

Side Effects
The potential adverse effects of splenectomy include the operative and postoperative complications of bleeding and infection. An important concern for late morbidity and mortality after splenectomy is the long-term risk of fatal bacterial infection, particularly in children less than 5 years old, in whom the risk may be 1 death per 300 to 1,000 patient years. Ref. Blood Vol 88 # 1 (July 1) 1996. pp 17. Review Article: "Idiopathic Thrombocytopenic Purpura: A practice Guideline Developed by Explicit Methods for The American Society of Hematology; James N. George et al.

Response Rate
30-40% of adults do not have a response to splenectomy or have a relapse sometime after undergoing splenectomy. Ref. N Engl J Med, Vol 346 # 13 , March 28, 2002 pp 1004.

Notes
Some patients develop accessory spleen and a second surgery is necessary. Surgical mortality is low with laparoscopy.