Protective effect of residual splenic tissue after subtotal splenectomy

Goldthorn, Jane F.; Schwartz, Allen D.; Swift, Andrea J.; Winkelstein, Jerry A.

doi:10.1016/s0022-3468(78)80098-0

Cited by 82 publications

(30 citation statements)

References 27 publications

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“…The significant splenic regeneration ob served at autopsy might conceivably be a pre requisite for the favorable outcome recorded in this group. These results agree closely with findings reported by others [8,12,14].…”

Section: Discussionsupporting

confidence: 94%

Splenic Resection or Heterotopic Transplantation of Splenic Tissue as Alternatives to Splenectomy

Alwmark¹,

Bengmark²,

Gullstrand³

et al. 1983

Eur Surg Res

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In 82 male Sprague-Dawley rats, divided into eight groups according to surgical procedure performed (total splenectomy, sham operation and six different modes of splenic conservation), resistance to intravenous injection of 4 × 10³ CFU of Streptococcus pneumoniae type I was evaluated 16 weeks after the surgical procedures. Significant regeneration of the spleen and almost normal resistance to pneumococci was seen 16 weeks after a two-thirds resection. Pieces of the spleen, implanted subcutaneously or into the greater omentum, also showed marked regeneration; though survival time was prolonged, the mortality among these animals following injection with pneumococci did not, however, differ from that of totally splenectomized animals. Dispersed splenic tissue, injected subcutaneously, intramuscularly, or retroperitoneally, showed less sign of regeneration and had no effect on mortality or survival time in partially vis-à-vis totally splenectomized rats.

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Section: Discussionsupporting

confidence: 94%

Splenic Resection or Heterotopic Transplantation of Splenic Tissue as Alternatives to Splenectomy

Alwmark¹,

Bengmark²,

Gullstrand³

et al. 1983

Eur Surg Res

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“…In a rat model of incremental partial splenic resection, animals could survive intravenous injection of S pneumoniae as long as 25% to 50% of the normal splenic tissue was preserved. 27,28 In humans, optimal protection is likely to depend on the residual splenic mass [29][30][31] and on the preservation of adequate blood flow. 32 To obtain a splenic remnant accounting for 25% of the volume of a normal spleen required that approximately 90% of the volume of an enlarged spleen be removed.…”

mentioning

confidence: 99%

Long-term evaluation of the beneficial effect of subtotal splenectomy for management of hereditary spherocytosis

Bader-Meunier

Gauthier

Archambaud

et al. 2001

Blood

145

112

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Clinical manifestations of hereditary spherocytosis (HS) can be abrogated by splenectomy. However, concerns exist regarding exposure of patients to a lifelong risk for overwhelming infections and, to a lesser extent, to vascular complications after total splenectomy. In the search for alternative treatment modalities, we assessed, in a previous pilot study, the potential usefulness of subtotal splenectomy in a small population of patients. During a mean follow-up period of 3.5 years, subtotal splenectomy was shown to be effective in decreasing the hemolytic rate, while maintaining the phagocytic function of the spleen. In the current study, we evaluated the clinical and biologic features of 40 patients with HS who underwent subtotal splenectomy and were monitored for periods ranging from 1 to 14 years. The beneficial effect of subtotal splenectomy included a sustained decrease in hemolytic rate and a continued maintenance of phagocytic function of the splenic remnant. However, mild-to-moderate hemolysis was persistent and accounted for secondary gallstone formation and aplastic crisis in a small subset of patients. Surprisingly, regrowth of the remnant spleen did not seem to have a major impact on the beneficial outcomes of these individuals. Our results suggest that subtotal splenectomy appears to be a reasonable treatment option for management of patients with HS, especially young children.

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“…Other authors [7,12] demonstrated a decreased resistance to infection in the animals subtotally splenectomized with a residual parenchyma of 25% compared to the hemisplenectomized ones.…”

Section: Discussionmentioning

confidence: 91%

“…The reduced resistance to these infections has been correlated to a reduction of phago cytic activity, synthesis of IgM, opsonins and leukophylic y-globulins [2,7,10,11].…”

Section: Discussionmentioning

confidence: 99%

Effect of Splenectomy and Hemisplenectomy on Pneumococcal Infection and Bacteria Clearance in the Rat

Pouché¹,

Savoldi

Colombi

et al. 1987

Eur Surg Res

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Median survival times 1 month after intraperitoneal inoculation of Streptococcus pneumoniae Felton UC 41 show that the difference between hemisplenectomized and control rats is not at all significant (χ² = 0.04). On the other hand, comparing splenectomized rats with hemisplenectomized and control rats taken together, there is a significant difference: 10% level (χ² = 2.84; 1 degree of freedom; p < 0.10). The blood concentrations of pneumococci at different time intervals after inoculation do not differ between control and hemisplenectomized rats (F = 0.02; 1 and 135 degrees of freedom), but they differ very significantly when the splenectomized rats are compared with the hemisplenectomized rats and controls taken together (F = 10.00; 1 and 135 degrees of freedom; p < 0.01).

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Protective effect of residual splenic tissue after subtotal splenectomy

Cited by 82 publications

References 27 publications

Splenic Resection or Heterotopic Transplantation of Splenic Tissue as Alternatives to Splenectomy

Splenic Resection or Heterotopic Transplantation of Splenic Tissue as Alternatives to Splenectomy

Long-term evaluation of the beneficial effect of subtotal splenectomy for management of hereditary spherocytosis

Effect of Splenectomy and Hemisplenectomy on Pneumococcal Infection and Bacteria Clearance in the Rat

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