Our Summary

The spleen, an organ in the body, can sometimes be damaged beyond repair, requiring its removal. However, the body still needs some of the functions the spleen provides. Researchers have been trying to solve this problem by reusing a part of the spleen and transplanting it back into the patient. This is known as splenic autotransplantation.

However, this procedure has been known to cause complications after surgery, such as abdominal abscesses, intestinal blockages, and torsion of the omentum, a layer of fatty tissue in the abdomen.

In this study, researchers tested a new technique to hopefully reduce these complications. They took a piece of the spleen and put it inside a pouch made from the omentum, then secured it where the original spleen used to be in 15 patients. They compared these patients to 17 others who just had their spleen removed.

Three months after surgery, they checked to see how the transplanted spleen was doing. They used a type of scan and a blood test to look for signs that the spleen was working properly. They found that in the patients who had the splenic autotransplantation, the spleen tissue was healthy and working fine, and there were no complications from the surgery. Also, these patients had a higher platelet count (a measure of how well the blood can clot) than those who did not have the transplant.

The researchers conclude that this new technique of splenic autotransplantation can restore spleen functions and has fewer complications than previous methods.

FAQs

  1. What is splenic autotransplantation and when is it typically performed?
  2. What are some potential postoperative complications of splenic autotransplantation and how does the new technique aim to overcome them?
  3. What were the results of the study comparing patients who underwent splenic autotransplantation to those who underwent splenectomy only?

Doctor’s Tip

One helpful tip a doctor might give a patient about splenectomy is to follow up with regular blood tests and imaging studies to monitor the function of the remaining splenic tissue or any autotransplanted splenic tissue. This can help detect any complications early on and ensure proper management.

Suitable For

Patients who are typically recommended for splenectomy include those with traumatic injuries to the spleen, such as in cases of abdominal trauma. In these cases, splenectomy may be necessary to stop internal bleeding and prevent further complications. Additionally, patients with certain hematologic disorders, such as idiopathic thrombocytopenic purpura (ITP) or hereditary spherocytosis, may also be recommended for splenectomy to manage their condition. Other indications for splenectomy may include splenic tumors, cysts, or abscesses that cannot be treated with other methods.

Timeline

Before splenectomy:

  1. Patient experiences abdominal trauma or another medical condition that requires removal of the spleen.
  2. Consultation with a healthcare provider to discuss the need for splenectomy and potential risks and benefits.
  3. Preoperative testing and preparation for the surgery.
  4. Splenectomy surgery is performed to remove the spleen.

After splenectomy:

  1. Splenic autotransplantation procedure is performed in which a segment of the spleen is implanted inside a pedunculated omental pouch and fixed in the native site of the spleen.
  2. Postoperative monitoring for any complications related to the splenic autotransplantation procedure.
  3. Evaluation of splenic functions using peripheral blood smear and abdominal contrast-enhanced computed tomography (CECT) 3 months postoperatively.
  4. Patients who underwent splenic autotransplantation show evidence of well-vascularised splenic tissue on CECT and normal peripheral blood smear without Howell-Jolly bodies.
  5. No postoperative complications related to splenic autotransplantation are observed.
  6. Platelet count after 3 months is significantly higher in patients who underwent splenectomy only.
  7. Restoration of splenic functions with minimum postoperative complications related to the procedure.

What to Ask Your Doctor

  1. What are the potential benefits of splenic autotransplantation compared to splenectomy alone?
  2. What are the potential risks and complications associated with splenic autotransplantation?
  3. How long does it typically take for a patient to recover from splenic autotransplantation surgery?
  4. How will the function of the implanted splenic tissue be monitored after the procedure?
  5. Are there any lifestyle changes or precautions that need to be taken after undergoing splenic autotransplantation?
  6. How will the patient’s immune system be affected by undergoing splenic autotransplantation?
  7. Are there any long-term effects or concerns that the patient should be aware of post-splenectomy and autotransplantation?
  8. What follow-up appointments or tests will be necessary after the procedure?

Reference

Authors: Badawy A, Bessa SS, Hussein A, Wael M, El-Sayes IA. Journal: ANZ J Surg. 2022 Mar;92(3):466-470. doi: 10.1111/ans.17384. Epub 2021 Nov 25. PMID: 34825450