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Original Article
January 2002

The Value of Partial Splenic Autotransplantation in Patients With Portal Hypertension: A Prospective Randomized Study

Author Affiliations

From the Department of General Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University of Medical Sciences, Guangzhou, Peoples Republic of China (Drs H. Zhang, Chen, Mapudengo, J. Zhang, and Song); and Departments of General Surgery and Transplantation (Drs H. Zhang and Kaiser) and Medical Psychology (Dr Exton), University Hospital Essen, Essen, Germany.

Arch Surg. 2002;137(1):89-93. doi:10.1001/archsurg.137.1.89

Hypothesis  Splenic autotransplantation plays a role in preserving immune function of the spleen in patients with portal hypertension and liver cirrhosis.

Design  Prospective randomized study.

Setting  University hospital.

Patients  Twenty patients (19 men and 1 woman; aged 33-80 years) suffering from portal hypertension and liver cirrhosis were randomly allocated into 2 groups. Each group consisted of 10 patients.

Interventions  All patients underwent modified Sugiura operation. In the control group, splenectomy was performed, while partial splenic autotransplantation into the retroperitoneal space was additionally completed in the splenic autotransplantation group.

Main Outcome Measures  Serum tuftsin and IgM were measured preoperatively and 2 months after surgery. Dynamic scintigraphy with technetium Tc 99m–labeled heat-damaged erythrocytes was performed at 2-month intervals during the 8-month follow-up.

Results  There was no statistical difference in the mortality of the groups. The preoperative levels of serum tuftsin and IgM showed no statistical difference between groups. However, although these measures had decreased remarkably in the control group 2 months after operation (P<.001 for serum tuftsin; P = .04 for serum IgM), they remained stable in the splenic autotransplantation group (P = .25 for serum tuftsin; P = .12 for serum IgM). Four patients within the splenic autotransplantation group showed positive scanning of the transplanted splenic fragment during follow-up, whereas there was no positive scanning in the control group.

Conclusion  Our results suggest that partial splenic autotransplantation can preserve immune function of the spleen, as measured by serum levels of tuftsin and IgM, in patients with portal hypertension and liver cirrhosis.