[Studies on post-splenectomy infection and immune activation by muramyl peptide. A new concept in the prevention of severe infections].

The existence of the overwhelming postsplenectomy infection syndrome in adults after traumatic splenectomy is discussed controversially. In this study the effects of splenectomy and spleen-preserving operations on outcome of experimental pneumococcemia of the pig were analyzed. Furthermore, the effect of the monocyte activator MTP-PE was assessed. Splenic operations had no influence on the used criteria of sepsis. Pretreatment with MTP-PE protected animals against development of septic leukocytopenia and led to an enhanced bacterial clearance. In addition, mortality of experimental sepsis was significantly decreased. Splenic preservation in adults after posttraumatic splenectomy does not seem to be warranted. On the other hand, the activator of the monocyte-macrophage-system seems to represent an effective regimen to prevent development of sepsis in high-risk patients.