Department of General Surgery, E. Muscatello Hospital, Augusta, SR, Italy.
Division of Hematology, AOU Policlinico Vittorio Emanuele, University of Catania, Catania, Italy.
World J Emerg Surg. 2020 Mar 4;15(1):17. doi: 10.1186/s13017-020-00299-z.
Splenectomy is sometimes necessary after abdominal trauma, but splenectomized patients are at risk of sepsis due to impaired immunological functions. To overcome this risk, autotransplantation of the spleen by using a new technique has been proposed, but so far, a demonstration of functionality of the transplanted tissue is lacking.
We therefore evaluated 5 patients who underwent a splenic autotransplant in comparison with 5 splenectomized patients without splenic autotransplant and 7 normal subjects.
We confirmed that the patients not undergoing autotransplantation, when compared to normal subjects, had a higher platelet count, higher percentage of micronucleated reticulocytes (p = 0.002), increased levels of naive B lymphocytes (p = 0.01), a defect of class-switched memory (p = 0.001) and class-unswitched memory B cells (p = 0.002), and increased levels of PD1 on T lymphocytes CD8+ (p = 0.08). In contrast, no significant differences for any of the abovementioned parameters were recorded between patients who underwent spleen autotransplantation and normal subjects.
These findings suggest that splenic autotransplantation is able to restore an adequate hemocatheretic activity as well as recover the immunological deficit after splenectomy.
腹部创伤后有时需要进行脾切除术，但脾切除患者由于免疫功能受损，有发生脓毒症的风险。为了克服这种风险，提出了使用新技术进行脾自体移植，但到目前为止，缺乏对移植组织功能的证明。
因此，我们评估了 5 例接受脾自体移植的患者，并与 5 例未进行脾自体移植的脾切除术患者和 7 例正常受试者进行了比较。
我们证实，与正常受试者相比，未进行自体移植的患者血小板计数更高，网织红细胞微核率更高（p=0.002），幼稚 B 淋巴细胞水平升高（p=0.01），类别转换记忆缺陷（p=0.001）和类别未转换记忆 B 细胞（p=0.002），以及 T 淋巴细胞 CD8+上 PD1 水平升高（p=0.08）。相比之下，进行脾自体移植的患者与正常受试者之间，上述任何参数均无显著差异。
这些发现表明，脾自体移植能够恢复脾切除术后足够的血液清除活性和免疫缺陷。
