The Value of Partial Splenic Autotransplantation in Patients With Portal Hypertension

Abstract

Setting: University hospital. Patients: Twenty patients (19 men and 1 woman; aged 33-80 years) suffering from portal hypertension and liver cirrhosis were randomly allocated into 2 groups. Each group consisted of 10 patients. Interventions: All patients underwent modified Sugiura operation. In the control group, splenectomy was performed, while partial splenic autotransplantation into the retroperitoneal space was additionally completed in the splenic autotransplantation group. Main Outcome Measures: Serum tuftsin and IgM were measured preoperatively and 2 months after surgery. Dynamic scintigraphy with technetium Tc 99m-labeled heat-damaged erythrocytes was performed at 2-month intervals during the 8-month follow-up. Results: There was no statistical difference in the mortality of the groups. The preoperative levels of serum tuftsin and IgM showed no statistical difference between groups. However, although these measures had decreased remarkably in the control group 2 months after operation (PϽ.001 for serum tuftsin; P =.04 for serum IgM), they remained stable in the splenic autotransplantation group (P =.25 for serum tuftsin; P =.12 for serum IgM). Four patients within the splenic autotransplantation group showed positive scanning of the transplanted splenic fragment during follow-up, whereas there was no positive scanning in the control group. RESULTS MORBIDITY AND MORTALITY An 80-year-old patient from the splenic autotransplantation group, who had had severe chronic obstructive pulmonary disease for more than 30 years, died of

A solution to the negative effects of splenectomy during colorectal trauma and surgery: an experimental study on splenic autotransplantation to the groin area

“…In the control group, splenectomy was performed, while in the study group, partial splenic autotransplantation into the retroperitoneal space was performed. Two months after the operation, spleen function, in terms of serum tuftsin and serum IgM levels, was stable in the autotransplantation group [ 32 ].…”

The Effects of Splenectomy and Autologous Spleen Transplantation on Complete Blood Count and Cell Morphology in a Porcine Model

“…Increase in total leukocyte count after splenectomy and autotransplantation of splenic tissue as well as persistent leukocytosis are main characteristics of white blood cell count in mice (Bessler et al, 2004), rabbits (Karagülle et al, 2007) and humans (Zhang et al, 2002). However, in present study the differences in the degree of leukocytosis among the groups were not detected, except on the fifth postoperative day when a significant decline in the total number of leukocytes in pigs with a transplanted tissue was established compared to the control group at the same day of the experiment.…”

“…Initial transient neutrophilia is followed by the persistent lymphocytosis and monocytosis. Increased leukocytosis accompanied by the significant left shift is found in patients, and often there are myelocytes or other precursor in the granulocytic series in their peripheral blood (Labar & Hauptmann, 1998;Tang et al, 2003;Zhang et al, 2002).…”

Changes in peripheral lymphocyte subsets in patients after partial microwave ablation of the spleen for secondary splenomegaly and hypersplenism: A preliminary study

“…Classic splenectomy is often associated with loss of splenic immune function and high morbidity and mortality rates [5]. Being aware of the importance of the spleen in the immune system, splenic conservative methods have gained prominence in treating benign conditions of this organ [6][7][8]. These methods aim at preserving part of the splenic anatomic structure to maintain its physiological functions (especially its immune function).…”