To the Editor.—Mizrahi et al1 conclude that "... autotransplantation of the spleen is a safe alternative method for preserving splenic function..." Their results confirm previously reported findings that splenic autotransplants regenerate, and that there is a negative correlation between the number of pitted red blood cells in the peripheral blood and the estimates of residual splenic tissue.2
There is, however, no evidence that a reduction in the number of circulating pitted red blood cells is related in any way to the role of the spleen in phagocytosis or in the regulation of the immune response. The removal of pits results from mechanical amputation as the red blood cell passes through the interendothelial pores in the lining of the splenic sinuses. The use of this as an index of the return of splenic phagocytic or immunologic function is inappropriate.3
The reported return of IgM immunoglobulin concentrations to normal
DREW PA, CLAYER MTR, JAMIESON GG. The Value of Splenic Autotransplantation. Arch Surg. 1990;125(9):1224. doi:10.1001/archsurg.1990.01410210150028
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