{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:48:57Z","timestamp":1780332537243,"version":"3.54.1"},"reference-count":41,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,17]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Some patients with visceral leishmaniasis (VL), or kala-azar, suffer relapses and low quality of life despite adequate drug therapy, especially those co-infected with HIV. Occasionally, physicians indicate splenectomy, but the benefit of the procedure needs to be analyzed systematically. Therefore, a retrospective open cohort study was conducted in Teresina, Brazil. Inpatients from a reference hospital with relapsing VL who had a rescue splenectomy between 2012 and 2019 after the nationally recommended drug therapy failed were studied. The procedure\u2019s risks and benefits were assessed in a limited-resource setting. The primary outcomes were surgical complications, complete blood count, CD4+ cell count, hospitalizations, survival time, and medical complications preceding death. Thirteen adult patients received medical and surgical indications of splenectomy (12 men and one woman). Eleven had HIV infection. Two had early and two had late complications. Four died, all of whom were infected with HIV. An additional HIV-coinfected patient, apart from the cohort, died just before surgery. The death rate after surgery was 13.3 overall and 22.1 per 100 person-years among HIV-infected patients (31% overall and 36%, respectively). The impressive rise of complete blood counts and reduction of blood transfusions and hospitalizations were observed among all patients. Also, a meaningful increase in CD4+ cells in HIV-infected patients was noted. Splenectomy may benefit patients with relapsing VL. However, before performing splenectomy, available combined drug therapy for VL should be tried.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0376","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T12:45:32Z","timestamp":1655729132000},"page":"342-348","source":"Crossref","is-referenced-by-count":12,"title":["Splenectomy in Patients with Visceral Leishmaniasis Resistant to Conventional Therapy and Secondary Prophylaxis: A Retrospective Cohort"],"prefix":"10.4269","volume":"107","author":[{"given":"Luis G. C.","family":"Reinaldo","sequence":"first","affiliation":[{"name":"University Hospital of the Federal University of Piau\u00ed, Teresina, Brazil;"},{"name":"Hospital Get\u00falio Vargas, Teresina, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimundo J. C.","family":"Ara\u00fajo-J\u00fanior","sequence":"additional","affiliation":[{"name":"University Hospital of the Federal University of Piau\u00ed, Teresina, Brazil;"},{"name":"Hospital Get\u00falio Vargas, Teresina, Brazil;"},{"name":"Department of Specialized Medicine, Federal University of Piau\u00ed, Teresina, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago M.","family":"Diniz","sequence":"additional","affiliation":[{"name":"University Hospital of the Federal University of Piau\u00ed, Teresina, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael D.","family":"Moura","sequence":"additional","affiliation":[{"name":"University Hospital of the Federal University of Piau\u00ed, Teresina, Brazil;"},{"name":"Department of Specialized Medicine, Federal University of Piau\u00ed, Teresina, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f4nio J.","family":"Meneses-Filho","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Federal University of Piau\u00ed, Teresina, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caio V. V. M.","family":"Furtado","sequence":"additional","affiliation":[{"name":"University Hospital of the Federal University of Piau\u00ed, Teresina, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Washington L. C.","family":"Santos","sequence":"additional","affiliation":[{"name":"Oswaldo Cruz Foundation, Gon\u00e7alo Moniz Institute, Salvador, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorcas L.","family":"Costa","sequence":"additional","affiliation":[{"name":"Maternal and Child Department, Federal University of Piau\u00ed, Teresina, Brazil;"},{"name":"Funda\u00e7\u00e3o Municipal de Sa\u00fade of Teresina;"},{"name":"Tropical Diseases Institute \u201cNatan Portella\u201d, Teresina, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsen D.","family":"Eul\u00e1lio","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Municipal de Sa\u00fade of Teresina;"},{"name":"Tropical Diseases Institute \u201cNatan Portella\u201d, Teresina, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel R.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Microbiology-Infectious Disease and Immunology, Faculty of Medicine, University Laval, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos H. 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