Impact of total splenectomy on peripheral lymphocytes and their subsets in patients with hypersplenism associated with cirrhotic portal hypertension

Yunfu Lv,Wan Yee Lau,Jinfang Zheng,Jincai Wu,Hongfei Wu,Min Zeng

doi:10.1038/s41598-021-00692-x

Yunfu Lv, Wan Yee Lau + Show 4 more

Open Access

https://doi.org/10.1038/s41598-021-00692-x

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Abstract

To study the impact of total splenectomy (TS) on peripheral lymphocytes and their subsets in patients with hypersplenism associated with cirrhotic portal hypertension (CPH). We studied 102 consecutive patients who received TS from January 2008 to January 2020 due to CPH-related hypersplenism. A similar number of healthy individuals are used as healthy controls (HC). The total lymphocyte counts and their percentages of B lymphocytes, total T lymphocytes (cluster of differentiation (CD)3+) and their subsets (CD4+, CD8+), and natural killer (NK) cells in preoperative peripheral blood samples in hypersplenism patients were significantly lower than that of the HCs (both P < 0.05). The total lymphocyte counts and percentages of B lymphocytes in peripheral blood were significantly increased 1 week and 1 month after TS when compared with the pre-TS values (P < 0.05). There was no significant difference in the percentages of NK cells before or after surgery (P > 0.05). However, the percentages of CD3+ cells was significantly higher 1 month after than before surgery (P < 0.001). The percentages of CD4+, and CD8+ T lymphocytes were significantly lower 1 week after surgery (P < 0.05), but they were significantly higher 1 month after surgery (P < 0.01). The CD4+:CD8+ ratio was not significantly different from those before surgery, and 1 week or 1 month after surgery (P > 0.05). Patients with hypersplenism associated with CPH were significantly immunosuppressed preoperatively. After TS, the total lymphocyte count and percentages of B lymphocytes, and total T lymphocytes and their subsets increased significantly, resulting in improved immune functions.

Highlights

Patients and methodsConsecutive patients with hypersplenism associated with cirrhotic portal hypertension who underwent TS at Hainan General Hospital (Hainan, China) from January 2008 to January 2020 were enrolled in this study
The results of the study showed for the first time that patients who were significantly immunocompromised before TS had their total lymphocyte counts, percentages of B lymphocytes and total T lymphocytes and their subsets to increase significantly after total splenectomy, with resultant improvements in immune function
The causes of immunocompromised status, which is of clinical importance, was discussed in this article to illustrate the indications for splenectomy in patients associated with liver cirrhosis and portal hypertension, as not all such patients should be subjected to splenectomy

Summary

Patients and methods

Consecutive patients with hypersplenism associated with cirrhotic portal hypertension who underwent TS at Hainan General Hospital (Hainan, China) from January 2008 to January 2020 were enrolled in this study. In the TS group of patients, peripheral blood was taken preoperatively to determine the total lymphocyte count, the percentages of B lymphocytes, NK lymphocytes, total T cells (CD3+) and T-cell subsets (CD4+ and CD8+), as well as counts of white blood cells (WBCs), red blood cells (RBCs) and platelets. These tests were repeated 1 week and 1 month after surgery.

Results

Discussion

Summary