Abstract
Spleen is a “mysterious” organ since with unique functions, and might be related to other pathology in the human body. Splenomegaly and hypersplenism can manifest following the development of portal hypertension in liver cirrhosis through fibrogenesis, immune and microenvironment dysregulation. Cirrhotic patients are generally considered as immunocompromised and prone to infections. Splenectomy in cirrhotic patients has produced concern over decrease immunity and elevated risk of infection, namely overwhelming post splenectomy pneumococcal sepsis. This review discus the splenectomy effect to the liver and how it can play a role in cirrhotic patients with portal hypertension without readily available access to liver transplantation.
Highlights
The spleen is a unique organ with many functions, including its crosstalk with the liver in cirrhotic patients
This review aims to answer a clinical question “Should splenectomy be done in liver cirrhosis with hypersplenism and splenomegaly?”
Spleen comprised of two distinct compartments, both functional and morphological, namely red pulp and white pulp
Summary
The spleen is an organ full of mystery, as stated by Galen. From the ancient times until the Renaissance, descriptions of the gross anatomy of the spleen were relatively accurate, yet the physiology of this organ remains incomplete and inaccurate. With one fourth of body’s lymphocytes stores in the spleen, it is the largest secondary organ which initiate immune response to blood-borne antigens [2]. It exerts important effects on local and systemic immune responses, which have the potential to affect different tissues and organs [3]. The B-lymphocytes within the germinal centers of the spleen are sites for the production of antibody activated by foreign antigen. The realization of this important immunological function has promoted the desire for splenic preservation [4]
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