Spleen transplantation: III. Autotransplantation of splenic slices into omental pouches in adults after trauma

Abstract

Recently preservation of traumatized spleen has been advocated. Splenic autotransplantation has been proposed as a method for preserving splenic function. This paper reports our experience with autotransplantation of splenic tissue in adults. During a 5-year period from 1981–1985, 102 patients with injured spleen underwent conservative surgery at our institute, 54 of whom received autotransplantation of splenic slices into omental pouches. One patient died of multiple organ failure 2 days after operation,. and another one developed adhesive intestinal obstruction and, therefore, required reoperation 5 months after the first surgical intervention. Histologic studies of this patient’s transplants revealed extensive fibrosis. 42 of the 54 patients were followed up, only 10 maintained a regular follow-up schedule. It was found that the neutrophil leukocyte to lymphocyte ratio was reversed in 7 cases, andα-naphthyl-acetate esterase assay showed the excessive peripheral lymphocytes to be mainly B lymphocytes. The size, volume, function and fibrosis of the transplants are also discussed.

Keywords

splenic autotransplantation / omental pouches / α-naphthyl-acetate esterase (ANAE)

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