Abstract
IntroductionSplenectomy is performed mostly because of traumatic events that cause rupture of the spleen. Postsplenectomy, a patient has a higher risk of developing sepsis. Autotransplantation of splenic tissue decreases the risk of opportunistic infection and sepsis, but its role in patients with human immunodeficiency virus is debated because the spleen is a replication site, especially during the asymptomatic phase of this infection. We present a case of a patient with human immunodeficiency virus infection who was admitted to our hospital for a traumatic rupture of the spleen and underwent spleen autotransplantation.Case presentationA 36-year-old Caucasian man was admitted to the shock trauma center of our hospital after a car accident. Anamnesis showed that the patient had been human immunodeficiency virus-positive for 13 years. A computed tomography scan showed abundant fluid collection in his superior and inferior abdomen caused by splenic rupture, with no other associated intra-abdominal lesions. During surgery, the spleen appeared severely damaged. A splenectomy was performed, and 35 g of splenic tissue was autotransplanted in a pouch created in the omentum. No complications occurred after surgery, and our patient was discharged from our hospital nine days after the operation. One year later, computed tomography and scintigraphy showed that the transplanted tissue was functioning well.ConclusionsAutotransplantation of splenic tissue decreases the risk of opportunistic infection and sepsis, and it might also be useful in patients with human immunodeficiency virus. Other studies need to be done to validate this hypothesis.
Highlights
Splenectomy is performed mostly because of traumatic events that cause rupture of the spleen
Autotransplantation of splenic tissue decreases the risk of opportunistic infection and sepsis, and it might be useful in patients with human immunodeficiency virus
Autotransplantation of splenic tissue decreases the risk of opportunistic infection and sepsis, but its role in patients with human immunodeficiency virus (HIV) is debated because the spleen is a replication site, especially in the asymptomatic phase of this infection [3]
Summary
Splenectomy is performed mostly because of traumatic events that cause rupture of the spleen [1]. Performing a splenectomy in patients with HIV can be considered as both a positive treatment and a risk, because it eliminates a possible source of infection while weakening the already compromised immune system of these patients. This case report discusses the case of a patient with splenic trauma that was treated successfully with autotransplantation of splenic tissue. Laboratory tests showed an increased number of leukocytes (12.3 × 103/μL; reference range, 4.1 to 10.9 × 103/μL), mostly neutrophils; and high levels of lactate dehydrogenase (778 U/L; reference range, 300 to 600 U/ L), creatine kinase (372 U/L; reference range, 38 to 190 U/L) and aspartate aminotransferase (63 U/L; reference range, 13 to 41 U/L). CT and scintigraphy showed that the transplanted tissue was functioning well
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