Association Between Splenectomy and Chronic Thromboembolic Pulmonary Hypertension: a Systematic Review and Meta-analysis

Overview

Journal BMJ Open

Specialty General Medicine

Date 2021 Feb 24

PMID 33622936

Citations 3

Authors

Liyan Zhang

Peijing Yan

Kehu Yang

Shanlian Wu

Yuping Bai

Xinyu Zhu

Xiaojie Chen

Li Li

Yunshan Cao

Min Zhang

Affiliations

Soon will be listed here.

Abstract

Objective: Whether splenectomy increases the risk of chronic thromboembolic pulmonary hypertension (CTEPH) remains unclear. We conducted a systematic review and meta-analysis to explore the association between splenectomy and CTEPH.

Design: Systematic review and meta-analysis.

Data Sources: PubMed, Embase and Cochrane Library databases.

Methods: Two authors independently searched and extracted the data. The Newcastle-Ottawa Scale and the Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used to assess the quality of the included studies, and each quality item was graded as low risk or high risk. A random-effects model was used to calculate different effective values.

Results: In total, 8 trials involving 6183 participants fulfilled the inclusion criteria. The overall pooled crude prevalence of splenectomy was 4.0% (95% CI 0.03 to 0.06, I=71.5%, p<0.001) in patients with CTEPH. Subgroup analysis showed a statistically significant high incidence of splenectomy in patients with CTEPH (OR=2.94, 95% CI 1.62 to 5.33, I=0.0%, p<0.001) compared with patients with pulmonary arterial hypertension. There was a significantly high incidence of splenectomy in patients with CTEPH (OR=5.59, 95% CI 2.12 to 14.74, I=0.0%, p<0.001) compared with patients with thromboembolism disease (venous thromboembolism or pulmonary embolism).

Conclusion: The prevalence of splenectomy in patients with CTEPH was 4.0% and CTEPH might be associated with splenectomy. However, high-quality prospective trials are needed.

Prospero Registration Number: CRD42020137591.

Citing Articles

Case Report: Dangerous liaisons between splenectomy and eltrombopag-induced chronic thromboembolic pulmonary hypertension in patients with immune thrombocytopenia: report of two cases and review of the literature.

Castelli R, Atzori E, Delitala A, Masala S, Micheluzzi V, Ponti E Front Cardiovasc Med. 2025; 12:1508574.

PMID: 40013124 PMC: 11861326. DOI: 10.3389/fcvm.2025.1508574.

A rare case of idiopathic portal hypertension with portopulmonary hypertension occurred following splenectomy with a change in portal hemodynamics.

Shigefuku R, Iwasa M, Yoshikawa K, Tanaka H, Tamai Y, Eguchi A Clin J Gastroenterol. 2024; 18(1):130-136.

PMID: 39668312 DOI: 10.1007/s12328-024-02072-0.

Successful management of postpartum venous thrombosis following splenectomy for traumatic splenic rupture: a case report.

Zhu H, Sang X, Wu H, Shen W, Wang Y, Yu L J Int Med Res. 2024; 52(5):3000605241255507.

PMID: 38749907 PMC: 11107327. DOI: 10.1177/03000605241255507.

Role of Partial Splenectomy in Hematologic Childhood Disorders.

Attina G, Triarico S, Romano A, Maurizi P, Mastrangelo S, Ruggiero A Pathogens. 2021; 10(11).

PMID: 34832592 PMC: 8620563. DOI: 10.3390/pathogens10111436.

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