Splenomegaly
Contents
Acceptability at Recruitment
DISCUSS with MO
Acceptability at CT / Work-Up
DISCUSS with MO
Individual at Risk
Donor/ Recipient
Explanation of Condition
When organs are larger than their normal range of sizes, suffix –megaly is added. Splenomegaly is, therefore, enlargement of the spleen, usually greater than 12 cm in diameter. There are multiple reasons why the spleen can be enlarged. This is usually related to the a disease process. Splenomegaly can be transient in response to an external stimulus. Here, the spleen enlarges, but with time, shrinks back to normal size. However, as many of the reasons are irreversible disorders, in most cases the presence of splenomegaly will rule out acceptance of the donor to the register. Please discuss all cases with MO to confirm. Some possible causes of splenomegaly are: malignant bone marrow disorders (myeloproliferative and lymphoprliferative neoplasms), infections (EBV, CMV, malaria, leishmaniasis, HIV, hepatitis), liver conditions causing portal hypertension, Gaucher’s disease, amyloidosis, haemolytic anaemia, autoimmune disorders (rheumatoid arthritis, SLE).
See also [1]
Guidance
Discuss all cases with MO. If splenomegaly has not resolved, consider only accepting for BM harvest donation if underlying condition does not otherwise preclude the donor from donating. Spleen enlarges in > 90% of donors with GCSF stimulation, usually this enlargement does not exceed 2 cm and settles within 14 days. However, donors with enlarged spleen are deemed to be too high risk for PBSC donation as GCSF stimulation can cause extremely serious but rare complication of splenic rupture. There will be causes of splenomegaly that will be transmitted from donor to recipient, for example: Polycythaemia Vera, SLE. However, there are situations where transient splenomegaly will be accepted, for example, once CMV infection has cleared.
Pseudonyms or Related Conditions
Large spleen
Hepatitis A , Hepatitis B , Hepatitis C , Hepatitis E, Hepatitis Of Unknown Origin
References
Stroncek D, Shawker T, Follmann D, Leitman SF. G-CSF-induced spleen size changes in peripheral blood progenitor cell donors. Transfusion. 2003 May;43(5):609-13. doi: 10.1046/j.1537-2995.2003.00384.x. PMID: 12702182.
Platzbecker U, Prange-Krex G, Bornhäuser M, Koch R, Soucek S, Aikele P, Haack A, Haag C, Schuler U, Berndt A, Rutt C, Ehninger G, Hölig K. Spleen enlargement in healthy donors during G-CSF mobilization of PBPCs. Transfusion. 2001 Feb;41(2):184-9. doi: 10.1046/j.1537-2995.2001.41020184.x. PMID: 11239220.
Version
Version 1, Edition 1
Date of Last Update
4th October 2021
