title: Circulating cellular and humoral elements of immune function following splenic arterial embolisation or splenectomy in trauma patients.
abstract: BACKGROUND
  Splenectomy impairs the ability to combat infection, especially with encapsulated organisms. However, there is limited understanding of the impact of splenic arterial embolisation on immune function. Our hypothesis was that embolisation would not impair systemic immune function. This study examines elements of cellular and humoral immunity in patients undergoing splenic embolisation or splenectomy for trauma.
  
  
  METHODS
  Splenic embolisation (SE) and splenectomy patients (S) were compared to blunt trauma patients without splenic injury (NS). Lymphocyte counts, natural-killer cells, serum complement (C3, C4), and properdin levels were assayed.
  
  
  RESULTS
  No significant differences in total, helper, or suppressor T-lymphocytes, complement (C3, C4), or properdin were found. B-lymphocyte counts were higher in S (602±445cells/mm(3)) than SE (238±114cells/mm(3)) or NS (293±153cells/mm(3)) (p=.003 for pairwise comparisons). S also had more natural killer T-cells than NS (325±170cells/mm(3) vs. 174±116cells/mm(3), p=.004).
  
  
  CONCLUSIONS
  Splenic embolisation does not alter the measured immunologic parameters. The absence of sensitive markers for splenic immune function limits the ability to assess the impact of embolisation for trauma.
authors.affiliation: Division of Trauma, Critical Care and Emergency Surgery, Department of Surgery, Wright State University Boonshoft School of Medicine and Miami Valley Hospital, Dayton, OH 45409, United States.
authors.forename: Mbaga S
authors.initials: MS
authors.lastname: Walusimbi
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Dominguez
authors.forename: Jean M
authors.initials: JM
authors.lastname: Sands
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Markert
authors.forename: Mary C
authors.initials: MC
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001402:B-Lymphocytes / Q000276:immunology*; D003176:Complement C3 / Q000378:metabolism; D003181:Complement C4 / Q000378:metabolism; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055611:Natural Killer T-Cells / Q000276:immunology*; D011414:Properdin / Q000378:metabolism; D012189:Retrospective Studies; D013156:Splenectomy; D013157:Splenic Artery; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000276:immunology* / Q000628:therapy
chemical_list: D003176:Complement C3; D003181:Complement C4; D011414:Properdin