Due to injury or necessary surgery (splenectomy), some people are lacking a spleen, the organ that filters the bloodstream and helps the body fight infection. You do not need your spleen to live a normal, healthy life. However, since the spleen performs some important tasks, people who do not have one are urged to take certain precautions.

What is a spleen?

The spleen is a fist-sized organ that sits under your rib cage on the left side of your abdomen. Unlike the stomach, liver, or kidneys, it is not directly connected to the other organs in your abdomen. Instead, the spleen is connected to your blood vessels, with an artery that brings blood to it and a vein which takes the blood away.

The spleen is composed of two types of tissues: the red pulp, which filters the blood, and the white pulp, which contains white blood cells that regulate inflammation and the body’s response to infection. Both types of tissue play roles in fighting pathogens (bacteria, viruses, fungi, or parasites) that cause infections.

What does red pulp normally do?

The red pulp removes red blood cells — which carry oxygen — when they are old, damaged, or infected. It harvests the iron from the old red blood cells for recycling into new blood cells. Usually new red blood cells are created by the bone marrow, but when blood counts are low or the bone marrow is not working well, the spleen can also make new red blood cells.

The loss of the spleen’s ability to filter out infected red blood cells increases risks associated with two parasitic infections, malaria and Babesia. Malaria is spread by mosquito bites in many parts of Africa, Asia, and South and Central America. Babesia is spread by tick bites in the Northeastern and upper Midwestern part of the USA (a different species of Babesia is found throughout Europe). People without a spleen should take extra precautions to avoid these infections if they live in or visit a region where malaria or Babesia are common.

An area in the red pulp called the marginal zone contains special white blood cells known as splenic macrophages that filter pathogens out of the blood. This is a particularly important defense against a type of bacteria coated in a capsule that resists many of the body’s other defenses. These bacteria can be tagged by antibodies produced by the white pulp of the spleen, then killed by the splenic macrophages.

Someone without a spleen is at increased risk of severe, or even deadly, infections from these encapsulated bacteria. Fortunately, vaccines significantly decrease the risk of these infections, and are available against the most common types (Streptococcus pneumoniae, Haemophilus influenza, and Neisseria meningitidis). Additionally, it is usually recommended that people without a spleen have antibiotics that they carry with them (often referred to as “pill in pocket”) and can take at the first sign of an infection,

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