Spleen function and spleen removal (splenectomy)

The spleen is an organ that sits at the top left side of your tummy, tucked under your rib cage. It is part of your immune system and it helps your body fight against infection. It makes white blood cells, stores blood, filters old worn-out blood cells and helps control the amount of blood going around your body.

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Causes of poor spleen function (hyposplenism)

Causes of having poor spleen function or no spleen function include:

  • having a spleen that may not work well
  • being born without a working spleen
  • having a spleen removed after an injury or because of illness.

If you have an injury to your spleen, it can cause a lot of bleeding — it is a medical emergency. Sometimes the best way to stop the bleeding is surgery to remove your spleen. The whole spleen is removed so you lose all of the functions of the spleen.

Illnesses that can cause your spleen to not function properly, include some:

  • blood cancers
  • liver conditions
  • inflammatory conditions.

Some blood cancers can spread to the spleen. To stop the spleen producing cancerous blood cells you may need cancer treatments to destroy or reduce the function of your spleen.

In some people, the spleen can function more than normal and destroy too many blood cells rather than just the old worn-out ones.

Symptoms of poor spleen function

If your spleen has been removed or functions poorly you are much more at risk of infection. The symptoms will depend on what type of infection you get.

When to get help after spleen removal (splenectomy)

Go to the emergency department or an after-hours service straight away if you have a high fever (above 38°C) or uncontrolled shaking (do not drive yourself if you are shaking). These are signs of possible severe infection.

See a doctor within 24 hours if you have a:

  • cough with yellow, green or brown mucus (phlegm)
  • moderate to severe sore throat
  • flu-like illness with tiredness, aching, headache, throwing up, runny poos or stomach pain.

Complications of no spleen or hyposplenism

If your spleen does not work properly or if you have no spleen, you have a higher risk of getting a serious infection.

Reducing your risks of infection

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You can get extra immunisations or vaccine boosters to reduce your risk of serious infections. Your healthcare provider can advise you which ones are recommended.

Get your immunisations 2 to 4 weeks before a planned spleen removal. If you have an unplanned spleen removal, you should get them after you have recovered from the operation.

You should also get them if you have been diagnosed with hyposplenism.

Your healthcare provider will talk to you about taking low-dose antibiotics daily for at least 2 years after having your spleen removed.

They can also prescribe you an emergency high-dose antibiotic. You take this if you are concerned about having an infection but cannot get to a healthcare provider straight away.

  • Ask your pharmacist to put the expiry date on your supply of emergency antibiotics.
  • Regularly check that they have not expired.
  • Always take a supply of antibiotics if you are away from home.

See a healthcare provider straight away if you are bitten by an animal or a person.

You are more likely than people with a functioning spleen to get an infection from a bite. You will need to get the wound thoroughly washed and dressed and you may need extra antibiotics.

Make sure you have all the recommended immunisations before travelling.

Malaria prevention

You are particularly at risk from malaria. It is best not to travel to areas where it is common (such as parts of Africa and Asia).

If you do travel to places with malaria, be very strict about taking antimalarial medications and avoiding mosquito bites.

Get specialist travel advice and take a supply of antibiotics with you.

Wear a medical alert bracelet or pendant that tells people you do not have a working spleen.

You can buy these online. You can also get an application form from your healthcare provider or the hospital that arranged your splenectomy. They need to sign the form.