In which patient population is splenectomy associated with significant risk due to thalassemia?

Children under 4 are at significant risk when undergoing splenectomy due to the effects of thalassemia. Thalassemia, a blood disorder affecting hemoglobin production, can lead to increased susceptibility to infections, particularly from encapsulated organisms due to functional asplenia or hyposplenism. The spleen plays a vital role in filtering bacteria from the bloodstream and mounting an immune response against infections.

In young children, particularly those under four years old, the immune system is still developing, and they are generally more vulnerable to infections. Splenectomy in this age group can greatly diminish their ability to combat infections, which is a significant concern. The risk of severe infections, particularly from encapsulated organisms like Streptococcus pneumoniae and Haemophilus influenzae, increases considerably after the loss of splenic function, especially in a population already compromised by thalassemia.

The other age groups, such as adults over 60, pregnant women, and teens aged 13-18, present varying levels of risk, but the very young population is uniquely susceptible due to their immature immune systems and the critical role the spleen plays in protecting against infections early in development. Therefore, splenectomy in children under 4 years old with