title: Assessment of immune cells and function of the residual spleen after subtotal splenectomy due to splenomegaly in cirrhotic patients.
abstract: BACKGROUND
  The spleen is thought to be central in regulating the immune system, a metabolic asset involved in endocrine function. Overwhelming postsplenectomy infection leads to a mortality rate of up to 50%. However, there is still controversy on performing subtotal splenectomy as treatment of splenomegaly due to portal hypertension in cirrhotic patients. In the present study, immunocytes and the indexes of splenic size, hemodynamics, hematology and immunology in the residual spleen were analyzed to support subtotal splenectomy due to splenomegaly.
  
  
  RESULTS
  In residual spleen, T lymphocytes mainly were focal aggregation in the periarterial lymphatic sheath. While B lymphocytes densely distributed in splenic corpuscle. In red pulp, macrophages were equally distributed in the xsplenic cord and adhered to the wall of splenic sinus with high density. The number of unit area T and B lymphocytes of splenic corpuscle and marginal zone as well as macrophages of red pulp were obviously increased in the residual spleen, while the number of macrophages didn't be changed among the three groups in white pulp. While there were some beneficial changes (i.e., Counts of platelet and leucocyte as well as serum proportion of CD3+ T cells, CD4+ T cells, CD8+ T cells were increased markedly; serum levels of M-CSF and GM-CSF were decreased significantly; The proportion of granulocyte, erythrocyte, megakaryocyte in bone marrow were changed obviously; But serum IgA, IgM, IgG, Tuftsin level, there was no significant difference; splenic artery flow volume, portal venous diameter and portal venous flow volume, a significant difference was observed in residual spleen) in the clinical indices.
  
  
  CONCLUSIONS
  After subtotal splenectomy with splenomegaly due to portal hypertension in cirrhotic patients, the number of unit area T and B lymphocytes, and MØ in red pulp of residual spleen increased significantly. However, whether increase of T, B lymphocytes and MØs in residual splenic tissue can enhance the immune function of the spleen, still need further research to confirm.
authors.affiliation: Center of General Surgery, The 89th Hospital of PLA, West Beigong Road 256, Weifang, 261021, China. haibochuwf@163.com.
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Chu
authors.affiliation: Department of Pathology, Weifang Medical University, Weifang, China. ztg0536@163.com.
authors.forename: Ting-Guo
authors.initials: TG
authors.lastname: Zhang
authors.affiliation: Center of General Surgery, The 89th Hospital of PLA, West Beigong Road 256, Weifang, 261021, China. jianhuazhao89yy@163.com.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Changyi People's Hospital, Weifang, China. fgjian@live.cn.
authors.forename: Feng-Guo
authors.initials: FG
authors.lastname: Jian
authors.affiliation: Center of General Surgery, The 89th Hospital of PLA, West Beigong Road 256, Weifang, 261021, China. xybwf@sina.com.
authors.forename: Yong-Bo
authors.initials: YB
authors.lastname: Xu
authors.affiliation: Departments of Pathology, The 89th Hospital of PLA, Weifang, China. wfbjwt@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.affiliation: Center of General Surgery, The 89th Hospital of PLA, West Beigong Road 256, Weifang, 261021, China. wangmin89yy@163.com.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Center of General Surgery, The 89th Hospital of PLA, West Beigong Road 256, Weifang, 261021, China. hnmrtjy981@163.com.
authors.forename: Jin-Yuan
authors.initials: JY
authors.lastname: Tang
authors.affiliation: Department of General Surgery, Changyi People's Hospital, Weifang, China. sunhongjie0000@126.com.
authors.forename: Hong-Jie
authors.initials: HJ
authors.lastname: Sun
authors.affiliation: Center of General Surgery, The 89th Hospital of PLA, West Beigong Road 256, Weifang, 261021, China. wfmclk@sina.com.cn.
authors.forename: Kun
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Pathology, Weifang Medical University, Weifang, China. guowj@wfmc.edu.cn.
authors.forename: Wen-Jun
authors.initials: WJ
authors.lastname: Guo
authors.affiliation: Center of General Surgery, The 89th Hospital of PLA, West Beigong Road 256, Weifang, 261021, China. xiaojizhu@163.com.
authors.forename: Xiao-Ji
authors.initials: XJ
authors.lastname: Zhu
mesh_terms: D000328:Adult; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000097:blood / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000097:blood / Q000276:immunology; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000097:blood / Q000276:immunology / Q000473:pathology / Q000601:surgery; D008214:Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood / Q000276:immunology; D008297:Male; D009000:Monocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D012189:Retrospective Studies; D013154:Spleen / Q000276:immunology / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D013156:Splenectomy; D013163:Splenomegaly / Q000097:blood / Q000276:immunology / Q000473:pathology / Q000601:surgery
chemical_list: D007136:Immunoglobulins; D016173:Macrophage Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor