To the Editor.—Peters et al1 concluded that splenectomy places renal transplant patients at a higher risk for infections, will decrease patient and graft survival rates, and is therefore contraindicated except for specific indications. They stated that each center has to evaluate its own results to determine the risk of splenectomy, but their overall conclusion was that splenectomy is detrimental. We disagree with their conclusion in general and believe their analysis is flawed for several reasons.
First, between 1970 and 1974, renal transplant recipients at their institution (University of Tennessee, Memphis) had splenectomies. From 1974 to 1980, adjunctive operations, such as bilateral nephrectomies and/or splenectomies, were performed only for specific indications; for splenectomy, the indications were hypersplenism and leukopenia. There were many patients who had early transplants at a time when, in general, patients tended to be overimmunosuppressed and patient treatment was not as good as in recent years.
SUTHERLAND DER, FRYD DS, SIMMONS RL, NAJARIAN JS. Splenectomy and Death in Renal Transplant Patients. Arch Surg. 1984;119(4):485-486. doi:10.1001/archsurg.1984.01390160107022