Abstract Background Splenic artery angioembolisation (SAE) plays an important role in the nonoperative management of blunt splenic injury. In contrast to splenectomy, there is little guidance concerning immune function, and consequently the need for antimicrobial prophylaxis, following SAE. A systematic review was conducted to evaluate the current literature on the topic. Method A systematic review of the currently available literature was performed using the MEDLINE database. Original articles were eligible if they reported at least one marker of splenic function following SAE. Animal studies, literature reviews and case reports were excluded. Two researchers independently assessed the eligibility and quality of the articles and performed the data extraction; these studies were qualitatively analysed. Results Eleven studies were included. A total of 407 patients, of which 243 had undergone SAE, 80 who had undergone splenectomy and 84 healthy controls, were included. All studies used different parameters for assessing splenic function. None reported increased rates of infection or overwhelming postsplenectomy infection following SAE. There was no statistically significant difference between the markers of immunocompetence measured in the SAE group when compared to healthy controls. Ten of the studies concluded that, by the parameters they measured, splenic function was preserved after the procedure. Conclusion All but one of the included studies reported preserved splenic function following SAE. Whilst there is no single parameter that unequivocally demonstrates this, the best available evidence supports this. This may help inform clinical guidelines for post-SAE vaccination and prophylactic antibiotic practice; namely, that there is no indication to do so.
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