A reappraisal of the role of splenectomy in children receiving renal allografts.

Four renal allograft recipients between 8 and 14 years of age died of acute fulminating infections less than 72 hours after the onset of symptoms. These patients all had undergone splenectomy at the time of related donor renal transplantation. Because the therapeutic value of splenectomy in renal transplantation has not been established, the role of adjunctive splenectomy is evaluated, and the relationship between splenectomy and overwhelming infection is discussed. As a result of these acute deaths in 4 of 62 children undergoing renal transplantation at this institution (6.4%), splenectomy in conjunction with renal transplantation in children has been discontinued.