Objective To improve the diagnosis and treatment of complications following spleen transplantation. Methods Five cases of spleen transplantation performed to treat severe hemophilia A were analyzed retrospectively .Results Hemorrhage was found in 2 cases that one was from small vessels of spleen porta and the other one was retroperitoneal hemorrhage. Acute rejection was diagnosed in early stage to all in which it happened to 1 case within 5 days, happened to 3 cases from the fifth day to the tenth postoperative day and happened to 1 cases after the tenth day. Infection was found in 2 patientsone with incision infection and the other with infection retroperitoneal infection. All but one who died from hydrocephalus recovered as a result of timely diagnosis and treatment.Conclusion It is of great significance to the recipients with transplanted spleen that the complications are detected comprehensively and treated in time.