Assessment of the sites of red cell destruction using quantitative measurements of splenic and hepatic red cell destruction.

Red cell survival, surface counting indices, the splenic and hepatic contribution to red cell destruction and the rate of splenic and hepatic red cell destruction were measured in 29 patients. Splenectomy was performed in 14. No correlation could be found between the splenic excess count index and both the amount and rate of red cell destruction in the spleen, but the rate of splenic and hepatic red cell destruction was related to the rate of disappearance of red cells from the circulation. The mean fractions of red cell destruction in spleen and liver were 46.1% +/- 20.5 (SD) and 11.7% +/- 4.2 (SD) respectively. After splenectomy, the haematocrit returned to normal in all patients despite fractions of red cell destruction in the spleen not exceeding 60%. Although the measurements of the splenic red cell destruction rate and of the fraction of red cell destruction in the spleen provide more precise information on the role of the spleen in red cell destruction, their prognostic value in patients who underwent splenectomy was not obvious.