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July 1983

Splenectomy and Death in Renal Transplant Patients

Author Affiliations

From the Transplantation Service, Department of Surgery, The University of Tennessee Center for the Health Sciences, Memphis.

Arch Surg. 1983;118(7):795-799. doi:10.1001/archsurg.1983.01390070007002

• To determine any association of splenectomy and death, 191 recipients of a single renal transplant were reviewed. Pretransplant splenectomy was performed in 90(47%) patients and the spleen was retained ("spleen-retaining") in 101 (53%). Sixty-eight patients (36%) died. Thirty-two fatal infections occurred in asplenic patients compared with ten infection-caused deaths in those retaining the spleen; 12 asplenic and 14 spleen-retaining patients died of noninfectious causes. Age, sex, graft source, HLA mismatch, and period of graft function were similar in asplenic and spleen-retaining patients who died. Prospective, multicenter, and single-center studies support divergent conclusions regarding the risks and benefits of splenectomy in transplantation. Study of specific center experience should precede adopting a policy of pretransplant splenectomy, an irreversible form of immunosuppression significantly related to fatal infection.

(Arch Surg 1983;118:795-799)

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