Acta Chirurgica 36. (1997)

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Acta Chirurgica Hungarica, 36 (1-4) pp. 349-351 (1997) SPLENIC AUTOTRANSPLANTATION AFTER ABDOMINAL TRAUMA IN CHILDHOOD. CLINICAL AND EXPERIMENTAL DATA T. Szendrői, Irén Mikó*, Z. Hajdú, G. Ács**, S. Kathy, I. Furka* and L. Szabó** Department of General Surgery of Kenézy Teaching Hospital, *Department of Experimental Surgery and Department of Traumatology, University Medical School of Debrecen H-4043 Debrecen, Bartók Béta и. 2-26, Hungary Splenectomy is known to increase the risk of overwhelming bacterial infection. There is a decrease in immunglobulin IgM and T-lymphocytes, primary antibody response to antigen challenge is impaired, altered opsonic function an Tuftsin deficiency are noted. Splenic autotransplantation has been suggested as a method of preserving function and this concept is supported by experiments in animals. Prior to operation on humans the technique was thoroughly elaborated and practised in animal experiments (dogs). After splenectomy, 6-8 thin segments (Furka’s "spleen chip") are placed in between the plates of the major omentum. Within the period of ten years out of 52 patients 11 children (4 girls, 7 boys) suffered from abdominal trauma underwent total splenectomy, and than autotransplantation in the Kenézy Hospital in Debrecen, Hungary. In several patients the postoperative follow-up radionuclid imaging, IgM, and Tuftsin levels, and the haematological changes (leukocytes, differential blood count, platelet count, iron level in serum) unambiguously confirmed the function of the splenic tissue. Introduction The first spleen resection and the first suture was carried out in 1590 and 1895 by Rosetti and the russian Zikoff, respectively [7]. There had been no essencial change in the treatment of injured spleens for 400 years until 1952 when a change in approach was initiated by King and Shumacker. The causes of death in their patients with sphaerocytosis who died of unimpressionable infection were explained by postsplenectomy conditions. It was them who introduced the term "Overwhelming Postsplenectomy Infection" (OPS1) syndrome. The incidence of this syndrome in adults was first recorded in 1970 [5]. The follow-up examination of patients who had undergone splenectomy revealed uncommonly high rates (4,25%) in the coincidence of sepsis of which 2,5% proved to be lethal. Pneumococcus, Meningococcus and E coli were detected as pathogens. Material and Methods Our examinations are divided into two groups. Prior to operation on humans the technique was thoroughly elaborated and practised in animal experiments (dogs). The procedure is as follows: after splenectomy, 6-8 thin segments are placed in between the plates of the major omentum following its lifting and spreading over a large sheet soaked 0231-4614 /97/ $ 5.00 © 1997 Akadémiai Kiadó, Budapest

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