Although new drugs such as Rituximab and Thrombopoietin analogs have been introduced in the treatment of ITP resistant to steroids, the splenectomy remains the gold standard for the therapy of resistant patients.12 At present ITP represent in many western series the larger indication to splenectomy.5,8,10 Splenectomy remains the only treatment that appears to have a long lasting effect in patients with ITP.12,61–63 Response rates are around 70% in children with chronic ITP and 60 % in adults. The gene discussed is THPO; the disease is autoimmune thrombocytopenic purpura.