Post traumatic splenic function depending on severity of injury and management

Oller-Sales, Benjamín; Troya-Díaz, José; Martínez-Arconada, María Jesús; Rodríguez, Nivardo; Pachá-González, Miguel Angel; Roca, Josep; Carrillo, Jorge; Riba-Jofré, Joaquim; Rodrigo, María José; Feliú, Evarist; Pujol-Borrell, Ricardo; Martínez-Cáceres, Eva

doi:10.1016/j.trsl.2010.12.017

Cited by 7 publications

(2 citation statements)

References 29 publications

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“…Spleen enlargement can also occur and is known as splenomegaly. Splenomegaly can be caused by obstruction of blood flow, underlying abnormality, infiltration, or antigenic stimulation [23][24][25][26][27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Telomerase-Positive Stem Cells in Adult Porcine and Adult Rat Spleens I. Totipotent Stem Cells

Young¹,

Limnios²,

Lochner³

et al. 2020

JRMBR

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Section: Introductionmentioning

confidence: 99%

Telomerase-Positive Stem Cells in Adult Porcine and Adult Rat Spleens I. Totipotent Stem Cells

Young¹,

Limnios²,

Lochner³

et al. 2020

JRMBR

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“…he spleen is one of the most commonly injured organs after blunt trauma (1,2). It is involved in the antibody response against infection, most importantly against encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae type B, and Neisseria meningitidis group C (3,4).…”

mentioning

confidence: 99%

Antibody Response to a T-Cell-Independent Antigen Is Preserved after Splenic Artery Embolization for Trauma

Olthof

Lammers

Leeuwen

et al. 2014

Clin. Vaccine Immunol.

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Splenic artery embolization (SAE) is increasingly being used as a nonoperative management strategy for patients with blunt splenic injury following trauma. The aim of this study was to assess the splenic function of patients who were embolized. A clinical study was performed, with splenic function assessed by examining the antibody response to polysaccharide antigens (pneumococcal 23-valent polysaccharide vaccine), B-cell subsets, and the presence of Howell-Jolly bodies (HJB). The data were compared to those obtained from splenectomized patients and healthy controls (HC) who had been included in a previously conducted study. A total of 30 patients were studied: 5 who had proximal SAE, 7 who had distal SAE, 8 who had a splenectomy, and 10 HC. The median vaccine-specific antibody response of the SAE patients (fold increase, 3.97) did not differ significantly from that of the HC (5.29; P ‫؍‬ 0.90); however, the median response of the splenectomized patients (2.30) did differ (P ‫؍‬ 0.003). In 2 of the proximally embolized patients and none of the distally embolized patients, the ratio of the IgG antibody level postvaccination compared to that prevaccination was <2. There were no significant differences in the absolute numbers of lymphocytes or B-cell subsets between the SAE patients and the HC. HJB were not observed in the SAE patients. The splenic immune function of embolized patients was preserved, and therefore routine vaccination appears not to be indicated. Although the median antibody responses did not differ between the patients who underwent proximal SAE and those who underwent distal SAE, 2 of the 5 proximally embolized patients had insufficient responses to vaccination, whereas none of the distally embolized patients exhibited an insufficient response. Further research should be done to confirm this finding.T he spleen is one of the most commonly injured organs after blunt trauma (1, 2). It is involved in the antibody response against infection, most importantly against encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae type B, and Neisseria meningitidis group C (3, 4). Other functions of the spleen include storing B and T lymphocytes, plasma cells, and iron and filtering the blood, including removing damaged or old erythrocytes.Surgery (splenectomy) has long been the preferred treatment strategy for patients with traumatic injury to the spleen. After a splenectomy, patients have an increased risk of developing an overwhelming postsplenectomy infection (OPSI), which occurs after only 0.5% of all splenectomies in trauma patients but carries a mortality rate of around 50% to 70% (5). The risk of OPSI was one of the driving factors behind the evolution toward the use of more nonoperative treatment (NOM) strategies for splenic injury.Splenic artery embolization (SAE) is a nonoperative treatment strategy that can be used as an adjunct to observation in cases with an arterial bleeding focus. Advantages of NOM over surgical treatment include the avoidance of surgery-associated complic...

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Optimal Management of Blunt Splenic Injury in the Geriatric Patient

Haan

2017

Geriatric Trauma and Acute Care Surgery

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Post traumatic splenic function depending on severity of injury and management

Cited by 7 publications

References 29 publications

Telomerase-Positive Stem Cells in Adult Porcine and Adult Rat Spleens I. Totipotent Stem Cells

Telomerase-Positive Stem Cells in Adult Porcine and Adult Rat Spleens I. Totipotent Stem Cells

Antibody Response to a T-Cell-Independent Antigen Is Preserved after Splenic Artery Embolization for Trauma

Optimal Management of Blunt Splenic Injury in the Geriatric Patient

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