Maruyama A, Sekikawa T
First Department of Surgery, Yamanashi Medical College, Japan.
Nihon Geka Gakkai Zasshi. 1991 May;92(5):567-76.
The increasing recognition of the danger of overwhelming postsplenectomy infection (OPSI) has led surgeons to attempt to maintain splenic function after spleen injury. One technique they use when splenorrhapy or partial splenectomy are not feasible is the deliberate autotransplantation of splenic tissue. But the amount of splenic tissue necessary to prevent OPSI remains controversial, and opinions differ about the importance of the location and size of the splenic fragments implanted. The mice were divided into five groups, I. splenectomy, II. splenectomy +30% of the spleen implanted intraperitoneal site, III. splenectomy +50% implanted intraperitoneally, IV. splenectomy +50% implanted subcutaneously and V. Sham operation. This study assessed the blood flow of the splenic tissue, increasing weight of splenic mass, histology, the serum level of the immunoglobulins (IgG, IgA, and IgM), pneumococcal antibody titers after vaccination, and survival after intravenous pneumococcal challenge. This study demonstrated that intraperitoneal transplantation showed better regeneration and afforded better protection from OPSI than subcutaneous transplantation. And 30 to 50 percent of the whole splenic tissue mass protected against experimental pneumococcal sepsis. The splenic autotransplants developed in volume and blood supply after 8 weeks, and immunologic function against infection recovered at the same time.
对脾切除术后暴发性感染（OPSI）危险性的日益认识，促使外科医生在脾损伤后试图保留脾功能。当脾修补术或部分脾切除术不可行时，他们采用的一种技术是脾组织的自体移植。但预防OPSI所需的脾组织量仍存在争议，对于植入的脾碎片的位置和大小的重要性也存在不同意见。将小鼠分为五组，I. 脾切除术，II. 脾切除术+30%脾脏植入腹腔内，III. 脾切除术+50%腹腔内植入，IV. 脾切除术+50%皮下植入，V. 假手术。本研究评估了脾组织的血流量、脾质量增加的重量、组织学、免疫球蛋白（IgG、IgA和IgM）的血清水平、接种疫苗后的肺炎球菌抗体滴度以及静脉注射肺炎球菌攻击后的存活率。本研究表明，腹腔内移植比皮下移植显示出更好的再生能力，并能更好地预防OPSI。整个脾组织质量的30%至50%可预防实验性肺炎球菌败血症。脾自体移植在8周后体积和血供增加，同时抗感染的免疫功能恢复。
