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Splenectomy is advised if, (a) the PRBC requirement is more than 220 mL/kg/year(5), (b) there is evidence of hypersplenism in form of leucopenia or thrombocytopenia or reduced RBC survival with splenic sequestration on Cr51 radioisotope studies, or (c) there is presence of massive splenomegaly leading to persistent abdominal discomfort.
