title: The value of partial splenic autotransplantation in patients with portal hypertension: a prospective randomized study.
abstract: 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.
authors.affiliation: Department of General Surgery and Transplantation, University Hospital Essen, Hufeland Str 55, 45122 Essen, Germany. hongweizhang67@hotmail.com
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhang
authors.forename: Jisheng
authors.initials: J
authors.lastname: Chen
authors.forename: Gernot M
authors.initials: GM
authors.lastname: Kaiser
authors.forename: Obetien
authors.initials: O
authors.lastname: Mapudengo
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Michael S
authors.initials: MS
authors.lastname: Exton
authors.forename: Erwei
authors.initials: E
authors.lastname: Song
mesh_terms: 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
chemical_list: D007075:Immunoglobulin M; D014405:Tuftsin