Preservation of the native spleen in multivisceral transplantation

Pediatr Transplant. 2013 Sep;17(6):556-60. doi: 10.1111/petr.12124.

Abstract

The native spleen is usually removed in patients undergoing MTV. The consequential asplenic state is associated with a high risk of sepsis, especially in immunosuppressed children. In contrast, the inclusion of an allogeneic spleen in multivisceral grafts has been associated with a high incidence of GVHD. We propose an alternative technique for patients undergoing MTV, consisting of the preservation of the native spleen. This approach avoids the additional risk of infection that characterizes the asplenic state without the detrimental side effects of the allogeneic spleen.

Keywords: children; multivisceral transplantation; retransplantation; spleen.

MeSH terms

  • Child, Preschool
  • Cohort Studies
  • Diabetes Mellitus / therapy
  • Female
  • Gallbladder Diseases / therapy
  • Graft vs Host Disease
  • Humans
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Intestinal Atresia / therapy
  • Intestinal Pseudo-Obstruction / therapy
  • Male
  • Organ Transplantation / methods*
  • Risk
  • Short Bowel Syndrome / therapy
  • Spleen / pathology
  • Spleen / surgery
  • Spleen / transplantation*
  • Time Factors
  • Tracheoesophageal Fistula / therapy

Substances

  • Immunosuppressive Agents

Supplementary concepts

  • Martinez-Frias Syndrome