Autotransplant of spleen tissue in children with schistosomiasis: evaluation of splenic function after splenosis

Brandt, Carlos Teixeira; Maciel, Dione Tavares; Caneca, Oyama Arruda Frei; Castro, Célia Maria Machado Barbosa de; Araújo, Lenísio Bragante de

doi:10.1590/s0074-02762001000900017

Cited by 15 publications

(1 citation statement)

References 22 publications

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“…However, the real need for total splenectomy has been questioned considering the apparently limited clinical relevance of coagulation and immunological alterations in HSS and the infection risks following this procedure [79]. Partial splenectomy or spleen autotransplantation with the peritoneal implant of spleen portions following total splenectomy are performed by some groups [77][78][79][115][116][117] but are not widely practiced. While the higher risk of infection with capsulated bacteria after splenectomy can be reduced by vaccinations, that of malaria is of concern [118], especially because the vast majority patients with HSS (who come from sub-Saharan Africa), will be exposed to malaria after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and clinical management of hepatosplenic schistosomiasis: A scoping review of the literature

et al. 2021

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Background Hepatosplenic schistosomiasis (HSS) is a disease caused by chronic infection with Schistosma spp. parasites residing in the mesenteric plexus; portal hypertension causing gastrointestinal bleeding is the most dangerous complication of this condition. HSS requires complex clinical management, but no specific guidelines exist. We aimed to provide a comprehensive picture of consolidated findings and knowledge gaps on the diagnosis and treatment of HSS. Methodology/principal findings We reviewed relevant original publications including patients with HSS with no coinfections, published in the past 40 years, identified through MEDLINE and EMBASE databases. Treatment with praziquantel and HSS-associated pulmonary hypertension were not investigated. Of the included 60 publications, 13 focused on diagnostic aspects, 45 on therapeutic aspects, and 2 on both aspects. Results were summarized using effect direction plots. The most common diagnostic approaches to stratify patients based on the risk of variceal bleeding included the use of ultrasonography and platelet counts; on the contrary, evaluation and use of noninvasive tools to guide the choice of therapeutic interventions are lacking. Publications on therapeutic aspects included treatment with beta-blockers, local management of esophageal varices, surgical procedures, and transjugular intrahepatic portosystemic shunt. Overall, treatment approaches and measured outcomes were heterogeneous, and data on interventions for primary prevention of gastrointestinal bleeding and on the long-term follow-up after interventions were lacking. Conclusions Most interventions have been developed on the basis of individual groups’ experiences and almost never rigorously compared; furthermore, there is a lack of data regarding which parameters can guide the choice of intervention. These results highlight a dramatic need for the implementation of rigorous prospective studies with long-term follow-up in different settings to fill such fundamental gaps, still present for a disease affecting millions of patients worldwide.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and clinical management of hepatosplenic schistosomiasis: A scoping review of the literature

et al. 2021

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Ten-Year Experience With Living Related Donated Splenic Transplantation for the Treatment of Hemophilia A

Jiang

Gao

Dai

et al. 2006

Transplantation Proceedings

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Howell-Jolly bodies and liver-spleen scanning for assessment of splenic filtrative function yields discordant results in renal transplant recipients

Araújo¹,

Orlando

Neves

et al. 2017

Medicine

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Given discrepancies between methods for diagnosing hyposplenism, the purpose of this study was to evaluate the effect of the spleen size on the correlation between the methods, and to propose a model for improving the interpretation. Patients with renal allografts were included, in whom the spleen was assessed using Doppler ultrasound, scintiscan, and the presence of Howell-Jolly bodies (HJBs) in peripheral smears. In 35 subjects, scintiscan and HJBs were normal (Group 0); 20 had an abnormal result in both methods (Group 1); 34 had discordant results with HJBs present (Group 2); and 14 had discordant results with decreased spleen uptake (Group 3). There was no association between HJBs and scintiscan. The patients of Groups 1 and 2 had smaller spleens. The patients with smaller spleen had more hematological evidence of hyposplenism and exhibit smaller discrepancies between the methods than patients with larger spleen. The spleen can tip the balance from a normal to impaired function provided that the spleen size is below the critical mass required to maintain splenic function. A mild impairment of phagocytic function and slight dyserythropoiesis along with a small spleen would result in decreased take up of radiocolloid or the appearance of HJBs in blood smears.

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Autotransplant of spleen tissue in children with schistosomiasis: evaluation of splenic function after splenosis

Cited by 15 publications

References 22 publications

Diagnosis and clinical management of hepatosplenic schistosomiasis: A scoping review of the literature

Diagnosis and clinical management of hepatosplenic schistosomiasis: A scoping review of the literature

Ten-Year Experience With Living Related Donated Splenic Transplantation for the Treatment of Hemophilia A

Howell-Jolly bodies and liver-spleen scanning for assessment of splenic filtrative function yields discordant results in renal transplant recipients

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