The value of partial splenic autotransplantation in patients with portal hypertension: a prospective randomized study.
OBJECTIVE
Splenic autotransplantation plays a role in preserving immune function of the spleen in patients with portal hypertension and liver cirrhosis.


METHODS
Prospective randomized study.


METHODS
University hospital.


METHODS
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.


METHODS
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.


METHODS
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 (P<.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.


CONCLUSIONS
Our results suggest that partial splenic autotransplantation can preserve immune function of the spleen, as measured by serum levels of tuftsin and IgM, in patients with portal hypertension and liver cirrhosis.
Zhang
Hongwei
H
Department of General Surgery and Transplantation, University Hospital Essen, Hufeland Str 55, 45122 Essen, Germany. hongweizhang67@hotmail.com
Chen
Jisheng
J
Kaiser
Gernot M
GM
Mapudengo
Obetien
O
Zhang
Jie
J
Exton
Michael S
MS
Song
Erwei
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D007075:Immunoglobulin M / Q000097:blood; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013154:Spleen / Q000000981:diagnostic imaging / Q000276:immunology* / Q000637:transplantation*; D014182:Transplantation, Autologous; D014405:Tuftsin / Q000097:blood
D007075:Immunoglobulin M; D014405:Tuftsin