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PubMedDate not supplied

Role of splenectomy in prevention of hemorrhagic enteritis and death from hemorrhagic enteritis virus in turkeys.

Hemorrhagic diarrhea, gross hemorrhagic enteritis, and death caused by intravenous virus injection of hemorrhagic enteritis virus (HEV) were prevented in otherwise susceptible turkey poults by surgical splenectomy. The splenectomized poults produced anti-HEV antibodies, which indicated that splenectomy did not completely prevent replication of the virus. These results indicate that the spleen is necessary for the development of the intestinal lesions of this disease. The role of a toxic factor in this disease is discussed.

Animals↗
PubMed1984

Raised IgE levels in beta-thalassaemia: correlation with splenectomy and hepatitis B virus infection.

IgE values obtained in 117 beta-thalassaemia patients were significantly higher than in age matched normal subjects. In 31 patients (26.5%) IgE levels were above 2 s.d. of normal values for age, but the frequency of IgE with reaginic activity was lower in patients (5.1%) than in controls (11.9%). The highest values were observed in splenectomized patients who were also positive for one or more serological markers of hepatitis B virus infection. The increase of IgE levels was directly correlated with the number of years after splenectomy, and patients with biopsy proven chronic liver disease had higher IgE levels than those without evidence of liver damage. On the other hand, IgE levels were not correlated with the number of transfusions, age, IgG, IgA, IgM levels or T cell subsets and mitogen responsiveness. These results show that beta-thalassaemia patients develop elevated IgE levels to which splenectomy and hepatitis B virus infection contribute in a synergistic manner.

Adolescent↗
PubMed1978

Survival of normal and magnesium-deficient erythrocytes in rats: effect of magnesium-deficient diet vs. splenectomy.

Magnesium deficiency in rats causes anemia, the mechanism of which is unknown. The effect of dietary magnesium, splenectomy, and magnesium content of erythrocytes on erythrocyte survival was studied in Fisher rats. Half of the animals were splenectomized, the remainder sham-splenectomized; each group was subdivided, and some were placed on a magnesium-deficient diet, the rest on a control diet. After 6 weeks, each of the four subgroups was divided, half were given 51Cr-labeled red cells from magnesium-deficient rats, the remainder, labeled normal red cells. The survival functions of the labeled erythrocytes were fitted to a mathematical model composed of both first-order and accelerating components. The results show that the most important factor influencing erythrocyte survival was dietary magnesium intake. The magnesium content of the transfused red cells affected erythrocyte survival only in the rats fed the control diet, whereas splenectomy affected erythrocyte survival only in rats receiving the magnesium-deficient diet. The accelerating component of the survival function was increased eightfold in the animals fed the magnesium-deficient diet, whereas much smaller changes occurred in the first-order components.

Animals↗
PubMed1981

Kidney transplantation by use of splenectomy and transfusions, cadaver haplotype matching, suppressor cell assays, and T-cell monitoring.

We attempted to modulate several determinants of the host immunologic profile to improve kidney transplant survival: (1) genotype matching of the cadaver donor with the recipient, (2) assessment in recipients of living related donors (LRD) for predisposition to generate suppressor cells in mixed lymphocyte culture (MLC), (3) pretransplant splenectomy and transfusions, and (4) posttransplant immunologic monitoring. Between January, 1979, and July, 1980, 48 primary renal transplants were performed and followed up between 6 and 24 months. Pretransplant splenectomy was performed, and transfusions were administered in 38 of 48 and 48 of 48 patients, respectively. Donors and recipients of 10 of 11 cadaveric transplants were genotyped and selected for one HLA haplotype identity. All 10 proved to also be one DR antigen matches. There were no cadaveric kidney losses, but one surgical antibody to T cell subtest were used to modulate rejection therapy. The LRD group (n = 37) included 13 HLA-identical, seven haploidentical low MLC reactors, and 17 haploidentical high MLC reactors. Three deaths occurred (diabetes and myocardial infarction, stroke, and pancreatitis). A three-component coculture assay was used in the LRD group before transplantation to determine the capacity to generate specific and nonspecific MLC suppressor cells. Suppressor cells were seen in 17 patients given standard immunosuppression postoperatively without rejection episodes. However, in 20 patients incapable of generating suppressor cells, seven biopsy-proved rejection episodes occurred. There were no kidney losses, with 44 of 48 surviving recipients demonstrating normal renal function.

Adolescent↗
PubMed1984

Demonstration of splenic functions following splenectomy and autologous spleen implantation.

Autologous splenic tissue was implanted in 14 patients undergoing splenectomy for traumatic rupture or peroperatively arising lesion of the spleen. To demonstrate function of the implanted splenic tissue, spleen scintigraphy using 99mTc-labelled heat-damaged autologous erythrocytes, and percentage measurement of vacuolated erythrocytes in peripheral blood were performed one and three months after the splenectomy. The spleen scans were positive in eight patients after one month and in 12 patients after three months, demonstrating splenic phagocytic function. The numbers of vacuolated erythrocytes also indicated some restoration of the pitting function due to the implanted splenic tissue. No alterations were seen in serum immunoglobulins, but a moderate thrombocytosis still persisted after three months. The clinical significance of implantation of autologous splenic tissue is discussed.

Adolescent↗
PubMed1984

[Partial conservation of the splenic parenchyma in the prevention of hyposplenism after splenectomy. A note on ponderal modifications of the residual parenchyma (experimental research)].

The authors appraise the weight modifications of residual splenic parenchyma after partial splenectomy (25%, 50%, 75%) in grown up rats. After the values of platelet rate in the blood had come back to standard, the residual spleens were removed and weighed. No difference of weight of the spleen was remarked in the control animals in which a mobilization of spleen and a resection of 500 mg. of hepatic parenchyma were performed; a difference of 0,15 g. (P greater than 0,05), 0,21 g. (P less than 0,05) and 0,18 g. (P less than 0,05) respectively was observed in rats with 25%, 50%, 75% splenectomy.

Animals↗
PubMed1978

The influence fo traumatic splenectomy on the volume of human platelets.

A rise in the blood platelet count and volume occurred in 11 patients following traumatic splenectomy. The pattern of the volume distribution, however, remained unchanged. This indicates an increased rate of platelet production, with the newly formed cells substantially larger than their preoperative counterparts, and can be interpreted in terms of a humoral factor of splenic origin that is able to exert its control over the bone marrow. The stable shape of the volume distribution, despite splenectomy, suggests the presence of an organ other than the spleen that is capable of maintaining the normal age distribution in the peripheral circulation, and the liver is proposed as a possible candidate for this role. The evidence, so far, has been circumstantial and further investigation will be required before definite conclusions can be drawn.

Blood Platelets↗
PubMed1983

Mechanisms of splenectomy protection in epinephrine-induced renal and cardiac necrosis.

This study was intended to elucidate the mechanism(s) of protection afforded by splenectomy against EPI-induced ATN and myocardial necrosis. Renal function parameters, hematocrit, circulating catecholamines (EPI and NE), serum enzymes (CPK and SGOT), and urinary PGE2 were measured before and during intravenous infusion of EPI (4 micrograms/kg/min for 6 hr) in intact and chronically splenectomized animals. All but serum enzymes were measured in another group of splenectomized animals that were implanted with small fragments of the autologous spleen (autoimplanted animals) 2 weeks prior to EPI infusion. Renal function tests and urinary PGE2 levels were monitored for several hours during the recovery period. The development of ARF in intact animals was accompanied by marked increases in circulating catecholamine levels, hematocrit, and serum enzymes and by a marked decrease in urinary PGE2 levels. These animals had diffuse ATN and hemorrhagic lesions of the heart (myocardial necrosis), and none survived. Chronically splenectomized animals were protected against the adverse effects of EPI infusion. The protected animals showed minimal elevation of circulating catecholamine levels and no changes in urinary PGE2 levels or hematocrit. Serum enzymes and renal and cardiac histopathology remained essentially normal in these animals. Implantation of autologous splenic tissue in splenectomized animals caused reversal of the protective effect of splenectomy. The response of autoimplanted animals to EPI infusion was in all respects similar to that in intact animals with the exception of hematocrit, which did not rise. All autoimplanted animals survived. They showed prompt recovery of renal function associated with significant increase of urinary PGE2 levels during the recovery period. Focal ATN was observed but no hemorrhagic lesion of the heart was found. From these observations we conclude the following: (1) high circulating NE and/or low renal (urinary) PGE2 activity are important in the pathogenesis of EPI-induced ARF, (2) the spleen may release some factor(s) that modulate plasma NE level and/or renal PGE2 activity during EPI infusion, (3) EPI-induced ARF may occur independently of myocardial necrosis, and (4) hematocrit has no major role in EPI-induced ARF.

Acute Kidney Injury↗
PubMed1978

[Stomach perforation and other complications after splenectomy].

The complications of 151 cases of splenectomy are analyzed, the methods of their prevention discussed. As a special complication two cases of gastric fistula following splenectomy are reported. As prevention we recommend several broad Lembert sutures to invert the entire danger zone.

Gastric Fistula↗
PubMedDate not supplied

Partial splenectomy for ruptured spleen.

The first case of a successful partial splenectomy for ruptured spleen in a Papua New Guinean child is reported. Conservative management had failed and at operation repair was impossible. In selected cases of splenic trauma partial splenectomy is the treatment of choice if repair is impossible, especially in children to conserve the protective functions of the spleen.

Adolescent↗
PubMed1984

Unusual response of lymphocytic lymphoma (not hairy cell leukaemia) to splenectomy without chemotherapy.

An unusual period of prolonged disease control after splenectomy without chemotherapy was achieved in 3 cases of B-cell lymphocytic lymphoma with pancytopenia, massive splenomegaly, minimal lymphadenopathy and circulating hairy cells. The finding of distinctive histopathological features in the bone marrow, lymph nodes and splenic tissue enabled this unusual condition to be characterized and differentiated from hairy cell leukaemia, which may have similar presenting features and in which response to splenectomy is generally good.

Aged↗
PubMed1983

[Immunological significance of splenectomy in gastric cancer surgery. Production of immunosuppressive factor in the spleen].

We studied immunological significance of splenectomy in gastric cancer surgery with special reference to serum suppressor factor. The results showed that the sera from splenic venous blood in advanced gastric cancer was more suppressive to PHA blastogenesis of normal lymphocytes and also higher in the values of circulating immune complexes, as compared to the sera from peripheral blood. Furthermore, the media from cultures of spleen cells of patients with advanced gastric cancer indicated to suppress PHA blastogenesis of normal lymphocytes, as compared to the media from cultures of peripheral lymphocytes of the same patients. The suppressive activity was more increased in the media from cultures of nonadherent cell population obtained from the spleen cells. From these data, it was suggested that the spleen of patients with advanced gastric cancer was capable of producing serum suppressor factor. Therefore, gastrectomy combined with splenectomy may be reasonable in patients with advanced gastric cancer.

Antigen-Antibody Complex↗
PubMed1983

[Significance of splenectomy in the treatment of cancer].

With inoculation of a large amount of tumor cells, the tumor growth of splenectomized mice was depressed compared to sham operated mice. On the contrary, with inoculation of a small amount of tumor cells the occurrence of tumor was lower in sham-operated mice. The effect of splenectomy on tumor growth was bidirectional depending on the dose of the inoculate. The effect was due to the production of the immunosuppressive factor in sera obtained from mice inoculated with a large but not small amount of tumor cells. Studies for the late survivals of 113 patients who had received curative total gastrectomy with or without splenectomy revealed that the non-splenectomized group showed a significantly better late survival rate than the splenectomized group when the splenic hilar lymph nodes were not involved with cancer metastasis.

Animals↗
PubMed1984

[Arteriovenous fistula of splenic vessels after splenectomy].

Arteriovenous fistula of the splenic vessels is a rare complication of splenectomy since only 7 cases (including the case reported herein by the authors) are presently known. Simultaneous ligation of the vessels seems to be an important causative factor; enzymatic necrosis of the vessel walls due to a minute peroperative trauma to the pancreatic tail is also a plausible mechanism. All fistulas have been recognized within two years after splenectomy. Clinical findings consist of various signs among which a continuous left flank murmur is the most constant. Cardiac repercussions are usually lacking. The fistula induces hepatic lesions which never evolve towards hepatic sclerosis or cirrhosis and are reversible after closure of the arteriovenous communication. Portal hypertension is present only when associated hepatic lesions block the portal blood flow. Until recent years, surgical closure of the fistula was performed with satisfying results. Recently, non surgical closure has become possible and seems suitable in poor-risk patients.

Arteriovenous Fistula↗
PubMed1984

Serious infections in adults following splenectomy for trauma.

Postsplenectomy sepsis in children is a well-recognized hazard. Few reports discuss the risk of sepsis in the asplenic adult. Case reports of 47 adults with serious infections following splenectomy for trauma were examined. We conclude that fulminant sepsis after splenectomy for trauma in adults is indeed a potential risk and that all such patients should receive penicillin prophylaxis and pneumococcal vaccine.

Adolescent↗
PubMed1984

Partial splenectomy for a splenic cyst.

Partial splenectomy for a large splenic cyst was performed in a seven-year-old girl referred for splenomegaly. The increased risk of sepsis in splenectomized patients induced the successful attempt at partial splenectomy. The surgical procedure described involved removal of the cyst while preserving as much of the spleen as possible. In view of the planocellular epithelial lining, the pathological diagnosis was of a rare congenital, intrasplenic cyst.

Child↗
PubMed1983

Resolution of factor X deficiency in primary amyloidosis following splenectomy.

A 57-year-old man with primary amyloidosis was initially seen with hematuria, cutaneous bleeding, and hepatosplenomegaly. Factor X was determined to be 10% to 16% of normal plasma values. Administration of vitamin K-dependent factor concentrate transiently improved in vitro clotting tests but did not alter the clinical course. Following a splenectomy, bleeding ceased and factor X levels returned to normal, remaining so despite discontinuation of factor concentrate infusion. Amyloid fibrils extracted from the patient's spleen were determined to be derived from lambda V1 light chains. The importance of splenectomy as an effective therapeutic modality is discussed.

Amyloidosis↗
PubMed1983

[Intensive therapy during splenectomy in patients with subleukemic myelosis].

On the basis of analysis of splenectomies in 25 patients in the terminal stage of subleukemic myelosis--myelofibrosis with the aim of prevention and treatment of complications and better endurability of splenectomy the authors have elaborated a complex of measures for intensive therapy such as conducting the operation under protection of donor thrombocytes, limited transfusion of the whole blood, early administration of antibiotics, heparin therapy and disaggregation therapy in postoperative therapy.

Adult↗