[Indication for splenectomy in hemolytic anemias].

The role of splenectomy in the management of hemolytic anemias seems to be established. However, when we decide the indication of this procedure in individual patients, we should make the final judgement after evaluating the following items. The items to be discussed include 1) cause and mechanism of hemolysis, 2) predominant site of red cell destruction, 3) evaluation of splenomegaly, 4) the age of the patient and the time of splenectomy, 5) complications of splenectomy and their proper management, and 6) alternative treatments (including drug therapy) to splenectomy. After splenectomy, it is important to advise the patients and their families to seek immediate medical attention for febrile illnesses.