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PubMed1978

[Long term effects of splenectomy on the immune-status of Hodgkin's disease patients depending on the modality of treatment (author's transl)].

In a total group of 103 Hodgkin's disease patients the immune-status of splenectomized and non-splenectomized individuals is compared in subgroups characterized by the modality of treatment (RT, CT, RCT). The mitogenic stimulation of peripheral lymphocytes showed a decreased response of splenectomized patients in each therapy group. The percentage, but not the absolute number/mm3, of peripheral T-cells was reduced after splenectomy. Splenectomized patients, who received combined radiation and chemotherapy showed significantly lower IgM-levels than non-splenectomized patients after the same treatment. EBV-VCA-titers and skin-test-reactivity were not influenced by splenectomy.

Hodgkin Disease↗
PubMed1988

[Su-polysaccharide skin test and immunotherapy with OK-432 in postoperative gastric cancer--the effect of a splenectomy].

A SU-polysaccharide skin test (SU-PS test) has been employed and studied as a parameter for monitoring the immunological status of OK-432 treated patients who had undergone a curative gastrectomy for a gastric cancer in stages II and III. The median diameter of the erythema (SU-PS value) was found to have no relation to the number of lymphocytes and the serum protein level and was depressed by combined chemotherapy. The SU-PS value was significantly higher in patients not given a splenectomy than in patients who had undergone a patients splenectomy. The spleen is considered the essential organ to focus on in OK-432 immunotherapy.

Aged↗
PubMed1988

[Efficacy of recombinant interferon alpha-2 in 34 patients with hairy cell leukemia. Effect of splenectomy and dosage reduction results of therapy].

In a retrospective study of 34 patients with hairy cell leukemia treated with recombinant interferon-alpha 2, we have observed a hematological remission rate of 97%. The true complete remission rate based on bone marrow findings was 17%. Although complete remissions can be obtained only in a few cases, treatment with interferon is justified in cytopenic patients since long-standing clinically meaningful improvement of the peripheral blood values can be attained. If interferon is stopped in the remission phase, the blood values deteriorate in 40% of the patients within 5 months. In contrast, it appears that the remission can be maintained with intermittent administration of interferon weekly or even every other week. As compared to splenectomized patients, granulocyte recovery is delayed in nonsplenectomized patients. However, after several months of treatment there is no difference in peripheral blood values between splenectomized and non-splenectomized patients. In the light of the present results, primary splenectomy remains justified in a selected group of patients for whom the risk of surgery (due to low granulocytes and/or platelets) is low and for whom careful evaluation predicts a high potential for long-standing remission after splenectomy. In the other cases, initial interferon therapy seems justified.

Adult↗
PubMed1988

Discordant heart xenografts in the rat. Additional effect of plasma exchange and cyclosporine, cyclophosphamide, or splenectomy in delaying hyperacute rejection.

Natural antidonor antibodies are known to play a prominent role in hyperacute xenograft rejection. The aim of this work was to devise an experimental protocol to prolong the survival time of guinea pig heart xenografts transplanted into rats. A technique of continuous plasma exchange adapted to small animals was used to remove the natural cytotoxic antibodies from the recipient prior to the transplantation. In some experiments, cyclosporine (CsA), cyclophosphamide (CY), or splenectomy were associated with the plasma exchange. In this highly discordant xenogenic donor-recipient combination, the mean graft survival time in nontreated rats was 16 min. When an exchange of 1.5 plasma volume was performed 24 hr before the transplantation, no prolongation of the graft survival time was observed. When CsA, CY, or splenectomy were associated with the plasma exchange, the graft survival time was significantly increased by more than 2500% (up to 418 min with CsA). When used isolately, none of these 3 immunosuppressive methods was able to prolong the graft survival time. Natural cytotoxic antibodies were monitored by a complement-mediated cytotoxicity assay. After a plasma exchange, the titers decreased from 1:16-1:32 to 1:1-1:2. When no immunosuppressive method was associated with the plasma exchange, the antibodies returned to their initial level within the 24 hr that preceded the transplantation, and the graft was rejected as in nontreated animals. When an immunosuppressive method was associated with the plasma exchange, and particularly in the case of CsA, the titers remained low, and the hyperacute rejection was delayed. Therefore, it can be concluded that plasma exchanges, associated with CsA, are an efficient experimental protocol in the rat to increase the survival time of guinea pig heart xenografts. The effect of the treatment is correlated with the decrease in natural cytotoxic antidonor antibodies.

Animals↗
PubMed1987

Splenectomy in the rat. Immediate and late effects on clearance of gram-negative bacteria and on monocyte activation as expressed by thromboplastin synthesis.

Young rats (weight 190-200 g) were subjected to splenectomy or sham laparotomy and gram-negative bacteraemia was induced by caecal perforation or by injection of viable Escherichia coli intraperitoneally (10(9) bacteria) or intravenously (2 X 10(8]. Clearance of bacteria was significantly less in the splenectomized than in the sham-laparotomized rats, irrespective of the mode of microbial inoculation. Monocyte thromboplastin activity, shown to be a sensitive indicator of gram-negative bacterial presence, was heightened in the asplenic rats. When the infectious challenge was made 15 weeks postoperatively, however, no significant difference in bacterial clearance or in monocyte thromboplastin values was found between splenectomized rats and controls. Nor was increased susceptibility to gram-negative bacteria found in asplenic rats when both operation (splenectomy vs. sham laparotomy) and bacterial challenge were performed at a late age (weight 530-580 g). The postsplenectomy clearance of gram-negative bacteria thus seemed to be age-dependent.

Animals↗
PubMed1987

[Partial splenectomy for epidermoid cysts of the spleen in children. Apropos of 3 cases].

Three cases of epidermoid cyst of the spleen treated by partial splenectomy are reported on children. The diagnosis rests now on the ultrasonography. The operative indication is systematic because of the risks of complication. The polar localisation of the cysts permits one to make a conservative surgery. The partial splenectomy is a technique of choice in this benign tumoral pathology. Postoperative digital intravenous subtraction angiography demonstrated the good vascularization of the remaining part of the spleen.

Adolescent↗
PubMedDate not supplied

[Pharmacokinetic characteristics of drugs in experimental splenectomy].

Pharmacokinetics of antipyrine, hexenal, phenylbutasone and caffeine was studied in experiments on splenectomized male rats. It was found that the half-life of all the drugs increased and plasma clearance decreased. Total protein binding assessed by using congo red decreased to a certain degree after splenectomy. The main factor modifying pharmacokinetics of drugs following splenectomy is believed to be depression of biotransformation processes in the liver.

Animals↗
PubMed1988

[Splenectomy in the treatment of idiopathic thrombopenic purpura in adults. Apropos of 43 cases].

Case reports of 43 patients with idiopathic thrombocytopenic purpura (ITP) operated upon from 1975 up to the present were analyzed. After revision of therapeutic indications the predictive prognostic factors for splenectomy, essentially the initial response to corticotherapy, were studied. Findings indicated that splenectomy is effective treatment for ITP since permanent total remissions were obtained in 76% with a morbidity of 16% and a mortality of 2%. Emphasis is placed on the need for minute pre-, intra- and post-operative precautions.

Adrenal Cortex Hormones↗
PubMed1987

[Morphological changes in splenic autotransplants following splenectomy: clinical and experimental studies].

Reports results of clinical, morphologic, and laboratory studies carried out in 18 patients allografted with spleen fragments into the greater omentum following splenectomy for a traumatic injury of the spleen, and in 20 splenectomized dogs allografted with spleen fragments or a spleen cell suspension into various parts of the abdominal cavity. Spleen tissue regeneration in the allografts was found to be nearing completion 6 to 8 weeks after the transplantation. The regeneration took less time to be completed in dogs grafted with spleen fragments than in those grafted with a cell suspension, but occurred at similar rates whatever the site in the abdominal cavity into which the fragments or suspension had been grafted. In the allografted patients, the incidence of posttransplantation suppurations was lower than in a similar group of patients who had undergone splenectomy without allografting.

Animals↗
PubMed1978

[Explorative laparotomy combined with splenectomy in malignant lymphomas (evaluation of 52 medical records) (author's transl)].

52 medical records of patients with malignant lymphomas, who had been treated by explorative laparotomy and splenectomy, were evaluated retrospectively. In all patients lymphography and splenic scintigraphy had been performed prior to surgical treatment, and in most of them additional liver scintigraphy. The splenic scintigram was true-positive in 11 cases, false-positive in 6, false-negative in 8, and true-negative in 27 cases. Lymphography was true-positive in 9 and false-positive in 17 cases, false-negative in 4 and true-negative in 22 cases. Comparison shows that explorative laparotomy and splenectomy, in spite of the postoperative complications which have been mentioned, cannot be replaced by modern diagnostic possibilities, provided that indication is carefully considered.

Adolescent↗
PubMed1986

Effects of splenectomy on the retention of Salmonella enteritidis and on the hemopoietic response to Salmonella infection.

Salmonella infection induces a marked increase in the splenic granulopoiesis, but causes a reduction in hemopoiesis in the bone marrow. In this study, effects of Salmonella enteritidis infection on hemopoietic stem cells were examined in splenectomized (SX-) mice. Splenectomy emphasized hemopoietic damage in the bone marrow caused by Salmonella infection. Total nucleated cells, pluripotent stem cells (CFUs) and granulocyte-macrophage progenitor cells (GM-CFC) in the bone marrow of SX-mice all decreased markedly compared with sham-splenectomized (NX-) mice, and the recovery from the decline was also delayed. Thus, neither enhancement of the granulopoiesis nor granulopoietic recovery in the bone marrow was observed to compensate the granulopoietic response in the spleen. Splenectomy also resulted in a longlasting retention of Salmonella in the liver. The observations indicate that the spleen is the major organ to respond to bacterial invasion in regard to enhanced granulopoiesis and hence enhanced bacterial clearance.

Animals↗
PubMed1986

Immunoarchitecture of the regenerating rat spleen: effects of partial splenectomy and heterotopic autotransplantation.

To investigate the microstructure of in situ (eutopic) and autotransplanted (ectopic) splenic remnants, adult Sprague-Dawley rats were studied 60 days after subtotal (approximately 80%) splenectomy, total splenectomy followed by single or multiple remnant intraperitoneal autotransplantation, or sham operation. Total nucleated cell counts were determined in excised splenic remnants, and immunohistochemical staining using monoclonal antibodies to rat B- and T-cell antigens was performed in serial tissue sections. Immunoarchitecture of eutopic remnants was indistinguishable from that of intact spleens and total nucleated cell counts remained proportional to weight. In contrast, ectopic remnants showed sparsity and abnormal mixing of B and T lymphocyte subpopulations with widespread loss of follicles and periarteriolar lymphoid sheaths in addition to lower density and marked reduction of total nucleated cells. These findings provide immunohistologic evidence that preservation of intact vasculature is critical to splenic architecture, which may account in part for the demonstrable functional inferiority of ectopic remnants.

Animals↗
PubMed1987

[Partial splenectomy in non-traumatic benign lesions of the spleen].

Partial splenectomy was performed in a patient with cystic lymphangioma and two patients with splenic pseudo-cysts, one of traumatic origin and the other necrotic following infarct. Anatomical features on which this operation is based, together with the technique employed, are exposed and the criteria of efficacy examined. Partial splenectomy was performed to reduce splenomegaly complicated with hypersplenism, and is also applicable for exeresis of cystic and pseudo-cystic splenic lesions. These indications are worthy of more extensive application in young adults.

Adult↗
PubMed1987

Bacteraemia in adults after splenectomy or splenic irradiation.

Between 1980 and 1985 eight patients who had had splenectomy or were hyposplenic were admitted to University Hospital, Nottingham with pyrexia and bacteraemia. Three of these patients died from fulminant sepsis, and one patient who had meningitis was left with serious neurological sequelae. All eight patients had had splenectomy or splenic irradiation for haematological disease. Str. pneumoniae was the commonest infecting organism. There were 1579 other bacteraemic episodes seen at University Hospital, Nottingham during the same period.

Adult↗
PubMed1987

A prospective multicenter trial with human recombinant alpha 2c-interferon in hairy cell leukemia before and after splenectomy.

Our multicenter study on the treatment of hairy cell leukemia (HCL) started in December 1984 and the present data cover the time up to June 30, 1986. Ninety-seven patients were enrolled. For induction of response daily doses (6 micrograms) of low dose human recombinant alpha 2c-interferon (arg) was chosen. Further dose reduction (3 micrograms) was possible for patients who improved within the first 3-4 weeks. Patients with known risk factors started at lower doses (0.6 microgram daily). As infections are known to be the main cause of death in HCL, splenectomy was not mandatory before treatment. Thirty-nine patients received treatment with interferon. Nevertheless, infections remained the major cause of death in the study. The protocol did not prevent fatal infections in nine of the 34 splenectomized patients. The regimen proved safe for all but one of the nonsplenectomized patients. According to this experience, new criteria are needed for the choice of primary treatment in HCL. In our opinion splenectomy should become restricted to selected cases.

Antineoplastic Agents↗
PubMedDate not supplied

Assessment of post-splenectomy residual splenic function. Splenic autotransplants.

Splenectomy increases the risk of fulminant sepsis. The present study assesses residual splenic function in patients splenectomized due to traumatic rupture of the spleen; and six cases with splenic autotransplants. Splenic tissue was observed in only 48% of the splenectomized patients and 100% of the autotransplant cases. The two most reliable analytical parameters to assess the presence of functional splenic tissue, were the absence of Howell-Jolly bodies and normal IgM blood levels. In cases where total splenectomy is indicated, it has proved useful to perform autotransplantation of splenic tissue at omentum major level.

Adolescent↗
PubMed1986

Hypocellular marrow and extramedullary hematopoiesis in a dog: hematologic recovery after splenectomy.

Nonregenerative anemia, poikilocytosis, thrombocytopenia, and splenomegaly were found in a 6-year-old dog. Marrow aspiration did not yield marrow particles, and microscopic examination of a marrow-core biopsy indicated hypocellular marrow. Marked extramedullary hematopoiesis was found in liver and spleen biopsy specimens. After splenectomy, the clinical and hematologic abnormalities resolved. The dog subsequently developed hemolytic anemia caused by Haemobartonella canis, which was resolved with oral tetracycline treatment. The dog remained healthy without recurrence of cytopenias or hypocellular marrow for 2 years after splenectomy. The clinical, hematologic, and microscopic findings in this dog were compatible with hypersplenism.

Animals↗