Immunologic function after splenic embolization, is there a difference?
BACKGROUND
To define the immunologic status of patients undergoing splenic embolization (SE) after traumatic injury. This information may lead to the development of immunization protocols based on scientific data.


METHODS
Patients with traumatic splenic injury, treated at one level II Trauma Center were eligible for study. SE patients were compared with splenectomy (SP) patients and controls (C = blunt abdominal trauma patients with negative abdominal computed tomography scans). Clinical examination, medical survey, blood sampling, and nuclear medicine spleen scans were performed. IgM, IgG, C3 complement, complement factor B, helper T cells (CD3, CD4), suppressor T-cells (CD8), complete blood counts, and HIV status were tested. Radionuclide spleen scans were analyzed for total spleen volume, splenic defects, abnormal radionuclide uptake, and ectopic sites of tracer uptake.


RESULTS
There were no significant differences in age, gender, or injury severity score among groups. Follow-up time was comparable (SP = 2.67 years; SE = 2.88 years). There were no significant differences in all studies measured except for higher CD8 levels in the SP group (730.1 vs. SE 452.1 vs. C 480.6; p = 0.002), although all values were within the normal range. CD3 levels showed a trend of being higher in the SP group (1709.3 vs. SE 1397.2 vs. C 1371.9), but were not statistically significant.


CONCLUSIONS
The data suggest that the immunologic profile of embolized patients is similar to controls. This supports the safe use of SE in managing the traumatically injured spleen. Larger studies examining the immune function after SE will be needed to make definitive vaccination recommendations.
Tominaga
Gail T
GT
Trauma Service, Scripps Memorial Hospital La Jolla, La Jolla, California 92037, USA. tominaga.gail@scrippshealth.org
Simon
Fred J
FJ
Dandan
Imad S
IS
Schaffer
Kathryn B
KB
Kraus
Jess F
JF
Kan
Michael
M
Carlson
Stephen R
SR
Moreland
Stephen
S
Nelson
Trevor
T
Schultz
Peter
P
Eastman
A Brent
AB
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004621:Embolization, Therapeutic; D005260:Female; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D007121:Immunocompetence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D013154:Spleen / Q000276:immunology* / Q000293:injuries*; D055815:Young Adult