Single segment of spleen autotransplantation, after splenectomy for trauma, can restore splenic functions

World J Emerg Surg. 2020 Mar 4;15(1):17. doi: 10.1186/s13017-020-00299-z.

Abstract

Background: Splenectomy is sometimes necessary after abdominal trauma, but splenectomized patients are at risk of sepsis due to impaired immunological functions. To overcome this risk, autotransplantation of the spleen by using a new technique has been proposed, but so far, a demonstration of functionality of the transplanted tissue is lacking.

Methods: We therefore evaluated 5 patients who underwent a splenic autotransplant in comparison with 5 splenectomized patients without splenic autotransplant and 7 normal subjects.

Results: We confirmed that the patients not undergoing autotransplantation, when compared to normal subjects, had a higher platelet count, higher percentage of micronucleated reticulocytes (p = 0.002), increased levels of naive B lymphocytes (p = 0.01), a defect of class-switched memory (p = 0.001) and class-unswitched memory B cells (p = 0.002), and increased levels of PD1 on T lymphocytes CD8+ (p = 0.08). In contrast, no significant differences for any of the abovementioned parameters were recorded between patients who underwent spleen autotransplantation and normal subjects.

Conclusion: These findings suggest that splenic autotransplantation is able to restore an adequate hemocatheretic activity as well as recover the immunological deficit after splenectomy.

Keywords: Abdominal trauma; Spleen; Splenectomy; Splenic autotransplantation; Splenic function.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Cell Count*
  • Case-Control Studies
  • Contrast Media
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spleen / diagnostic imaging
  • Spleen / injuries*
  • Spleen / transplantation*
  • Splenectomy / methods*
  • Tomography, X-Ray Computed
  • Transplantation, Autologous*

Substances

  • Biomarkers
  • Contrast Media