【Abstract】Objective To explore the effect and indication of splenectomy in liver transplantation. Methods From January 2001 to April 2006, 260 patients underwent piggyback orthotopic liver transplantation (PBOLT), and 28 patients had undergone combined PBOLT and splenectomy (splenectomy group). These patients were compared to 56 randomly selected non-splenectomy patients from the same transplant period, meaningly two controls were selected for every non-splenectomy case. Two groups were analyzed with respect to rate of infection and survival rate, as well as biopsy-proven acute allograft rejection within 30 days after transplantation. Results Rate of infection in the splenectomy group was higher than that in the non-splenectomy patients (85.7% vs 55.4%, P＜0.05). Acute rejection and survival rates in the splenectomy group were lower than those in the non-splenectomy patients (3.6% vs 14.3%, P＜0.05; 46.4% vs 82.1%, P＜0.05). Conclusion Concomitant splenectomy with PBOLT has a significantly higher patient mortality rate; it is mainly due to its septic complications. At present, unless there is a certain indication for splenectomy, this procedure is not recommended.
Citation：
YE Qifa,SHE Xingguo,MING Yingzi,CHENG Ke,MA Ying,NIU Ying,REN Zuhai,LIU Bin,ZHAO Yujun. Effect of Splenectomy in Prognosis of Human Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(3): 158-161. doi:
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- 1. 9 Kita Y, Harihara Y, Hirata M, et al. Splenectomy for idiopathic thrombocytopenic purpura after living-related liver transplantation
[Ｊ] . Transplantation, 2000; 70(3) ∶ 553.
- 2. 王伟林, 高磊, 梁廷波, 等. 脾切除对肝移植患者的影响 [Ｊ]. 中华医学杂志, 2006; 86(18)∶1240.
- 3. Cescon M, Sugawara Y, Takayama T, et al. Role of splenectomy in living-donor liver transplantation for adults [Ｊ]. Hepatogastroenterology, 2002; 49(45)∶721.
- 4. 叶启发， 陈知水， 曾凡军, 等. 50例次背驮式肝移植技术回顾分析 [Ｊ]. 中华器官移植杂志， 2001; 22(5)∶282.
- 5. Austyn JM, Kupiec-Weglinski JW, Hankins DF, et al. Migration patterns of dendritic cells in the mouse. Homing to T cell-dependent areas of spleen, and binding within marginal zone [Ｊ]. J Exp Med, 1988; 167(2)∶646.
- 6. Troisi R, Colle I, Van Vlierberghe H, et al. Splenectomy and liver transplantation [Ｊ]. Transplant Proc, 2001; 33(1-2)∶1500.
- 7. Neumann UP, Langrehr JM, Kaisers U, et al. Simultaneous splenectomy increases risk for opportunistic pneumonia in patients after liver transplantation [Ｊ]. Transpl Int, 2002; 15(5)∶226.
- 8. Samimi F, Irish WD, Eghtesad B, et al. Role of splenectomy in human liver transplantation under modern-day immunosuppression [Ｊ]. Dig Dis Sci, 1998; 43(9)∶1931.
- 9. Nagappan K, David G, Paul M, et al. Splenectomy and liver transplantation:outcome and sepsis-related mortality [Ｊ]. Transplantation, 1999； 67(9)∶S633.
