Auto-Transplantation of Splenic Fragments After Total Splenectomy in Patients with Severe Splenic Trauma Lesions: A Clinical Study

Background: The known early and late complications following splenectomy increase the tendency to preserve splenic tissue after splenic trauma. Objectives: This study was conducted to determine the safety and feasibility of auto-transplantation of splenic fragments in patients with severe splenic injury. Methods: Nineteen patients with severe splenic blunt trauma, who underwent total splenectomy and autotransplantation of splenic fragments at Besat hospital, Hamadan University of Medical Sciences, Iran during years ۲۰۱۵ and ۲۰۱۶, were enrolled in the study. Complete blood counts, blood smear for Howell-Jolly bodies, and phagocytic function tests were performed just before, at ۳ months, and ۶ months after surgery. Results: The means of red blood cell counts increased significantly at both ۳ and ۶ months after surgery (P = ۰.۰۱ and ۰.۰۴۹, respectively) and the means of hemoglobin, hematocrit, and the percentage of lymphocytes increased significantly at ۳ months after surgery (P = ۰.۰۰۱, ۰.۰۴۶, and ۰.۰۱ respectively) while this increase was not significant ۶ months after surgery (P = ۰.۵۲, ۰.۱۵, and ۰.۳۴, respectively). The Howell-Jolly bodies were present in ۵ patients (۲۶.۳%) at ۳ months after surgery, which was significantly reduced to ۳ (۱۵.۸%), at ۶ months after surgery (P = ۰.۰۴۲). The median of splenic phagocytic function significantly increased from ۳ ± ۱.۲ hotspots (range = ۲ to ۶) at ۳ months after surgery to ۴ ± ۱.۴ (range = ۲ to ۸) at ۶ months after surgery (P = ۰.۰۴۴). Conclusions: Auto-transplantation of splenic fragments may be feasible and safe and a suitable option for splenic tissue salvage in patients with severe splenic lesions, who require total splenectomy.

Keywords:

splenectomy , Trauma , Autotransplantation