Abstract
To examine the possible late complications of splenectomy or spleen autotransplantation in large laboratory animal model, in which we need non-invasive or minimal-invasive methods for long-term monitoring of the experimental animals. Experimental groups of beagle dogs were: non-operated control, sham-operated control, splenectomy, spleen autotransplantation with 5 or 10 spleen-chips taken into the greater omentum (Furka's technique). Prior to operations, on the 1(st) postoperative week, monthly till the 6(th) as well as in the 9(th) and 12(th) month, hemorheological examinations were performed. In postoperative 12(th) month colloid scintigraphy and diagnostic laparoscopy were carried out. At the end of the investigation comparative morphological examinations were performed, too. From the 4(th)-5(th) postoperative month filtration function of spleen-autotransplants showed particular restoration compared to splenectomy group. However, the functional results did not reach the values of the control or sham-operated groups. Sham-operated control's scintigraphy nicely showed activity in the spleen. In spleen autotransplantation-groups scintigraphy indicated well the activity of spleen-chips. During diagnostic laparoscopy spleen-chips with their blood supply were found. Histologically, the structure of spleen-autotransplants was similar to normal splenic tissue. The autotransplants are regenerated, their functions have been partly restored, and thus spleen autotransplantation may prevent the possible complications of splenectomy. These parameters and the presented investigative protocol are suitable for long-term following-up of viability of the spleen-autotransplants.
Highlights
In the ancient times the spleen was considered a “mystic” organ without any function
Changes in erythrocyte deformability The changes in the relative cell transit time (RCTT) in the function of time are presented on Figure 1
From the 6th postoperative month we observed that the values of the spleen autotransplantation with 10 spleen chips group (AU10) were lower than the values in the splenectomy group
Summary
In the ancient times the spleen was considered a “mystic” organ without any function. It has become clear that spleen has complex functions. Recent studies have showed its role in lipid-metabolism, too[1,2,3,4,5,6]. In the clinical practice the early and late complications following splenectomy have been known for a long time[2,7,8], but the explanation for the late complications was given only by recent research on spleen surgery and spleen-sparing operations[8]. Some of the early complications are not specific to splenectomy: for example bleeding, infection, fever, gastrointestinal motility disorders, sterile wound healing disorders, thrombosis, pancreatitis can be concidered as general surgical complications. Some of the late complications can be related to the loss of splenic functions: decreased serum IgM, presence of abnormal erythrocytes in the blood, leukocytosis, thrombocytosis, Overwhelming Postsplenectomy Infection (OPSI) Syndrome, atherosclerosis, recurrent infections[6,7,8]
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