Autotransplantacija slezine

Abstract

Auto transplantation of the spleen can be performed in the patients with traumatic rupture of the spleen, in whom spleen could not be conserved in the other way. The right indication for this method is isolated rupture of the spleen (concvasation or complete devascularisation). This method is not recommended in the endangered patients, patients with previous disease of the spleen as well as in the patients with the perforation of the other abdominal organs at the same time. Auto transplantation was performed in 12 patients with isolated splenic rupture and hematoperitoneum, 11 men and one woman. The majority of patients are younger. In 8 patients, autotransplant was placed into big omentum, in three into lipomatous tissue surrounding left kidney, and in one into anterior abdominal wall. In all the patients from this group, following analysis were taken: MCV (middle volume of erythrocytes), HTC, Hb, Le, Glucose, urea, creatinin, sodium, potassium, alkali phosphatasis, target cells, Howell Jolly's bodies, Heinz's bodies, IgG, IgA, IgM, C3, C4, T3, T4, T8, B, segmentated, eosinophiles, lymphocytes, reticulocytes, thrombocytes, fibrinogen, PT, APTT, aggregation of thrombocytes and aggregation of thrombocytes on collagen. The same parameters were taken in 12 patients with surgery similar to splenectomy and in 12 after splenectomy. After splenectomy, there was decrease of the immunologic defending abilities of the organism because of the loss of the childrens function of the spleen, decreased level of the opsonines and tutsin, which leads to the impaired phagocytosis, decreased concentration of IgM and T and B lymphocytes, while in patients after auto transplantation the results were physiological. The most important thing in the assessment of the function of the autotransplanted spleen is scintigraphic investigation using 99mTc-denaturated red blood cells. In our study, auto transplant function was assessed in 10/12 patients by scintigraphy. Five years after surgery, no one patient was proved to have postsplenectomic sepsis.

Late histological aspects of spleen autologous transplantation in rats

“…Like this, there are several publications about spleen autotransplantation in humans 5,7,13,14,15 . Recently, Petroianu and Petronianu 16 related the technique of spleen autotransplantation for the treatment of hypertension portal.…”

“…The implant viability is influenced by several factors, such as it size, it forms and place. Several techniques were adopted for the verification of the implants, which could be implanted the whole organ, or a portion as varies from 25 to 50%, or a homogenized tissue form 5,7,8 .…”

“…Besides, it is discussed if the viability is superior in the implants of smaller fragments for regenerating in less time than the larger implants 9,10 . As for the location of the implants, several places have been studied: great omentum, peritoneal cavity, splenic store, retroperitoneum, intraportal, abdominal muscle, armpits and subcutaneous of abdominal wall 7,10 . The greater omentum has several advantages, as the accentuated vascularization, allowing great sanguine contribution, that it is resulted essential for its appropriate revascularization, which avoids the migration of the implant, and its permanence in the portal territory.…”

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

“…In addition, it has been reported that removal of the spleen causes significantly higher increase of reticulocyte count than other surgeries. This suggests that spleen may somehow hormonally regulate the release of red blood cells into circulation, thus after removal of spleen bone marrow releases more red blood cells as well as more immature erythrocytes into the blood stream (Knežević et al, 2002;Lorber, 1958). Splenectomy also causes changes in number of white blood cells with subsequent leukocytosis (Bessler et al, 2004;Karagülle et al, 2007).…”

Histological aspects of autologous transplantation of different fragments of the spleen in rats

“…Besides, it is discussed if the viability is superior in the implants of smaller fragments for regenerating in less time than the larger implants 4,5 . As for the location of the implants, several places have been studied: great omentum, peritoneal cavity, splenic store, retroperitoneum, intraportal, abdominal muscle, armpits and subcutaneous of abdominal wall 5,6 .…”