Patient: How do you think about the indications, timing and results of splenectomy for autoimmune hemolytic anemia? Shan Yandong: Regarding when to cut the spleen for autoimmune hemolytic anemia, my opinion is that cutting the spleen is definitely not the first choice. We should consider cutting the spleen only when all other medications cannot control the effect, or when some patients have other diseases that affect the use of medications for this disease, such as diabetes mellitus, and hormones are contraindicated. However, in general, if hormonal treatment is not effective, the effect of spleen excision is often not very satisfactory, so spleen excision in the treatment of immune hemolytic anemia should be very cautious and is only a last resort. Regarding the issue of transfusion for hemolytic diseases, because it is autoimmune hemolytic anemia and PNH, if we want to transfuse blood, we’d better choose red blood cells after washing, even after washing, especially in patients with PNH, hemolysis may still occur, because the complement is likely to be brought into the patient’s body when transfusing red blood cells, thus stimulating hemolysis. Regarding other congenital hemolysis, the effect of blood transfusion is not satisfactory, whether the hemolysis will be accelerated after transfusion is not certain, in most cases it is not, but the effect achieved after transfusion is maintained for a relatively short period of time. I mentioned a patient called MDS-PNH syndrome, this syndrome is not recognized yet, this kind of patient after the transfusion effect is not good, I think it is a very difficult problem, I may not have any good ideas myself.