The authors present influence of splenectomy (SE) on immune profile in a grup of 73 patients (mean age 9.95±3.4 years) examined in 1989-2001. They were divided according to diagnoses into three groups: 1st - haemolytic anaemia (HA) (32 patients), 2nd - idiopatic thrombocytopenic purpura (ITP) (30 patients) and 3rd - rupture of the spleen (11 patients). Control group involved 30 children. Changes of immune parameters were observed in the groups of patients with HA and ITP and controls before SE. Changes of immune profiles after SE in all three groups were observed considering the interval from SE (6 weeks, 6 months, and 1-10 years) to check-up. The most significant changes resulting from SE were found in cellular specific immunity with CD4/CD8 ratio decreasing, decrease of helper CD4+ T-lymphocytes percentage, decrease of naive CD45+RA+CD4+ T-lymphocytes in all three groups of patients. After SE decrease of microbicidal activity of neutrophils was found in the patients with HA and ITP and in all groups of patients decrease of phagocytic activities of neutrophils was found. The significant decrease of IgM was found in the group of patients with ITP and HA till seven and eight years after SE. From further opsonins, that was a significant decrease of C3 component of the complement, which is an essential indicator of monitoring after SE. On the basis of the above findings the authors recommend to monitor all stated laboratory parameters, recommend 3 years of antibiotic prophylaxis afterSE in patients with haematological diseases and 1 year in patients after SE due to rupture of the spleen with good immune profile. For patients with immunodeficiency it is recommended to take antibiotic prophylaxis until adjustment of immunodeficiency providing lifelong availability of a broad-spectrum antibiotic in case of acute infection.

        Key words: splenectomy, cellular specific immunity, humoral immunity, microbicidal and phagocytic activity, haematological diseases