脾切除术对首例尸体肾移植的影响。
Effect of splenectomy on first cadaver kidney transplants.
作者信息
Stuart F P, Reckard C R, Ketel B L, Schulak J A
出版信息
Ann Surg. 1980;192(4):553-61. doi: 10.1097/00000658-198010000-00013.
A prospective study was begun in January 1975 to evaluate the effect of splenectomy on graft and patient survival in recipients of first cadaver kidney transplants. Ninety-two cases were evaluated. Splenectomy increased the survival of both grafts and recipients. The benefit from splenectomy compensated readily for the perioperative morbidity of splenectomy and the long-term increased risk of sepsis from certain bacteria for the asplenic patient. Splenectomy exerted its effect by reducing the incidence and intensity of rejection episodes. It was not clear whether the observation resulted from a direct immunosuppressive effect of splenectomy or from the increased tolerance to azathioprine observed in asplenic recipients. Finally, splenectomy negated an effect of race that had been observed earlier for survival of cadaver transplants and recipients.
1975年1月开始了一项前瞻性研究，以评估脾切除术对首次尸体肾移植受者移植物和患者存活的影响。对92例病例进行了评估。脾切除术提高了移植物和受者的存活率。脾切除术带来的益处很容易弥补脾切除术的围手术期发病率以及无脾患者因某些细菌导致的败血症长期风险增加。脾切除术通过降低排斥反应的发生率和强度发挥作用。尚不清楚这一观察结果是源于脾切除术的直接免疫抑制作用，还是源于无脾受者对硫唑嘌呤耐受性的增加。最后，脾切除术消除了先前观察到的种族对尸体移植受者存活的影响。
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