The American Journal of Medicine
Volume 121, Issue 5 , Pages 371-375 , May 2008

Complications of Splenectomy

  • Ali Cadili, MD

      Affiliations

    • University of Alberta, Alberta, Canada
    • Corresponding Author InformationRequests for reprints should be addressed to Ali Cadili, MD, University of Alberta Hospital, Edmonton T6G 2B7, Alberta, Canada.
    • ,
  • Chris de Gara, MD, FRCS(c)

      Affiliations

    • Royal Alexandra Hospital, Alberta, Canada.

References 

  1. Chulkind ML, Ellis EF, Smith RT. Effect of antibody upon clearance of I-125-labelled pneumococci by the spleen and liver. Pediatr Res. 1967;1:178–184
  2. Rowley DA. The formation of circulating antibody in the splenectomized human being following intravenous injection of heterologous erythrocytes. J Immunol. 1950;65:515
  3. Eichner ER. Splenic function: normal, too much and too little. Am J Med. 1979;66:311–320
  4. Constantopoulos A, Najjar VA, Wish JB, et al. Defective phagocytosis due to tuftsin deficiency in splenectomized subjects. Am J Dis Child. 1973;125:663–665
  5. Spirer Z, Weisman Y, Zakuth V, et al. Decreased serum tuftsin concentrations in sickle cell disease. Arch Dis Child. 1980;55:566–567
  6. Dickerman JD. Bacterial infection and the asplenic host: a review. J Trauma. 1976;16:662–668
  7. Bishart N, Omari H, Lavi I, Raz R. Risk of infection and death among post-splenectomy patients. J Infect. 2001;43:182–186
  8. Cullingford GL, Watkins DN, Watts AD, Mallon DF. Severe late postsplenectomy infection. Br J Surg. 1991;78:716–721
  9. Waghorn DJ. Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed. J Clin Pathol. 2001;54:214–218
  10. Green JB, Shackford SR, Sise MJ, Fridlund P. Late septic complications in adults following splenectomy for trauma: a prospective analysis in 144 patients. J Trauma. 1986;26:999–1004
  11. Soda K, Kawakami M, Takagi S, et al. Splenectomy before tumor inoculation prolongs the survival time of cachectic mice. Cancer Immunol Immunother. 1995;41:203–209
  12. Fotiadis C, Zografos G, Aronis K, et al. The effect of various types of splenectomy on the development of B-16 melanoma in mice. Int J Surg Investig. 1999;1:113–120
  13. Schwarz RE, Hiserodt JC. Effects of splenectomy on the development of tumor-specific immunity. J Surg Res. 1990;48:448–453
  14. Kossoy G, Ben-Hur H, Lifschitz O, Zusman I. Mammary tumors in splenectomized rats. Oncol Rep. 2002;9:185–188
  15. Mellemkjøer MS, Jø Rgen H, Olsen MD, et al. Cancer risk after splenectomy. Cancer. 1995;75:577–583
  16. Linet MS, Nyrén O, Gridley G, et al. Risk of cancer following splenectomy. Int J Cancer. 1996;66:611–616
  17. Robinette CD, Fraumeni JF. Splenectomy and subsequent mortality in veterans of the 1939-45 war. Lancet. 1977;2:127–129
  18. Chung CT, Bogart JA, Adams JF, et al. Increased risk of breast cancer in splenectomized patients undergoing radiation therapy for Hodgkin's disease. Int J Radiat Oncol Biol Phys. 1997;37:405–409
  19. Kunisaki C, Makino H, Suwa H, et al. Impact of splenectomy in patients with gastric adenocarcinoma of the cardia. J Gastrointest Surg. 2007;11:1039–1044
  20. Otsuji E, Yamaguchi T, Sawai K, et al. Total gastrectomy with simultaneous pancreaticosplenectomy or splenectomy in patients with advanced gastric carcinoma. Br J Cancer. 1999;79:1789–1793
  21. Otsuji E, Yamaguchi T, Sawai K, et al. End results of simultaneous pancreatectomy, splenectomy and total gastrectomy for patients with gastric carcinoma. Br J Cancer. 1997;75:1219–1223
  22. Schwarz RE, Harrison LE, Conlon KC, et al. The impact of splenectomy on outcomes after resection of pancreatic adenocarcinoma. J Am Coll Surg. 1999;188:516–521
  23. Davis CJ, Ilstrup DM, Pemberton JH. Influence of splenectomy on survival rate of patients with colorectal cancer. Am J Surg. 1988;155:173-117
  24. Edward Black, Jason Niamat, Srikanth Boddu, et al. Unplanned splenectomy during oesophagectomy does not affect survival. Eur J Cardiothorac Surg. 2006;29:244–247
  25. Robertson DA, Swinson CM, Hall R, Losowsky MS. Coeliac disease, splenic function, and malignancy. Gut. 1982;23:666–669
  26. Chosa E, Hara M, Watanabe A, et al. Spleen plays an important role in maintaining tolerance after removal of the vascularized heart graft. Transplantation. 2007;83:1226–1233
  27. Peterson S, Strzalka C, Johnkoski J, et al. Combination of cyclosporine and splenectomy suppresses interleukin-6 production and major histocompatibility complex class II expression and prolongs cardiac xenograft survival. J Thorac Cardiovasc Surg. 1994;107:1001–1005
  28. Quarantillo P, Araneda D, Thomas F, Thomas J. Prolongation of cardiac xenograft survival by pre- and posttransplant splenectomy is associated with a decrease in anti-donor antibody titers. Transplant Proc. 1993;25(1 Pt 1):387–388
  29. Xu H, Gundry RS, Hancock WW, et al. Effects of pretransplant splenectomy and immunosuppression of humoral immunity in a pig-to-newborn goat cardiac xenograft model. Transplant Proc. 2000;32:1010–1014
  30. Sutherland DE, Fryd DS, So SK, et al. Long-term effect of splenectomy versus no splenectomy in renal transplant patients (Reanalysis of a randomized prospective study). Transplantation. 1984;38:619–624
  31. Locke JE, Zachary AA, Haas M, et al. The utility of splenectomy as rescue treatment for severe acute antibody mediated rejection. Am J Transplant. 2007;7:842–846
  32. Hall HG, Rice HE, Skinner MA, et al. Splenectomy prior to umbilical cord blood transplantation facilitates hematologic engraftment in pediatric and adult patients. Blood. 2003;102:11
  33. Hall JG, Kurtzberg J, Szabolcs P, et al. Partial splenectomy before a hematopoietic stem cell transplantation in children. J Pediatr Surg. 2005;40:221–227
  34. Stamou KM, Toutouzas KG, Kekis PB, et al. Prospective study of the incidence and risk factors of postsplenectomy thrombosis of the portal, mesenteric, and splenic veins. Arch Surg. 2006;141:663–669
  35. Winslow ER, Brunt LM, Drebin JA, et al. Portal vein thrombosis after splenectomy. Am J Surg. 2002;184:631–636
  36. Fujita F, Lyass S, Otsuka K, et al. Portal vein thrombosis following splenectomy: identification of risk factors. Am Surg. 2003;69:951–956
  37. Hassn A, AI-Fallouji MA, Ouf TI, et al. Portal vein thrombosis following splenectomy. Br J Surg. 2000;87:362–373
  38. Petit P, Bret PM, Atri M, et al. Splenic vein thrombosis after splenectomy: frequency and role of imaging. Radiology. 1994;190:65–68
  39. Romano F, Caprotti R, Conti M, et al. Thrombosis of the splenoportal axis after splenectomy. Langenbecks Arch Surg. 2006;391:483–488
  40. Greisshammer M, Bangerter M, Sauer T, et al. Aetiology and clinical significance of thrombocytosis: analysis of 732 patients with an elevated platelet count. J Intern Med. 1999;245:295–300
  41. Ikeda M, Sekimoto M, Takiguchi S, et al. High incidence of thrombosis of the portal venous system after laparoscopic splenectomy. Ann Surg. 2005;241:208–216
  42. Sheikha AK, Salih ZT, Kasnazan KH, et al. Prevention of overwhelming postsplenectomy infection in thalassemia patients by partial rather than total splenectomy. Can J Surg. 2007;50:382–386
  43. Tang WH, Wu FL, Huang MK, Friess H. Splenic tissue autotransplantation in rabbits: no restoration of host defense. Langenbecks Arch Surg. 2003;387:379–385
  44. Smith E, Young DJ, Drew PA. Decreased phagocytic capacity of autotransplanted splenic tissue. ANZ J Surg. 2003;73:894–896
  45. Sato S. Experimental study on function of regenerated splenic tissue after splenic autotransplantation. Nippon Geka Gakkai Zasshi. 1990;91:1720–1730
  46. Smith E, De Young NJ, Drew PA. Immune cell subpopulations in regenerated splenic tissue in rats. Aust N Z J Surg. 1999;69:522–525
  47. Sipka S, Bráth E, Tóth FF, et al. Cellular and serological changes in the peripheral blood of splenectomized and spleen autotransplanted mice. Transpl Immunol. 2006;16:99–104
  48. Sipka S, Brath E, Toth FF, et al. Distribution of peripheral blood cells in mice after splenectomy or autotransplantation. Microsurgery. 2006;26:43–49
  49. Shokouh-Amiri MH, Kharazmi A, Rahimi-Saber S, et al. Phagocyte function after splenic autotransplantation. Arch Surg. 1990;125:595–597
  50. Miko I, Brath E, Nemeth N, et al. Hematological, hemorheological, immunological, and morphological studies of spleen autotransplantation in mice: preliminary results. Microsurgery. 2003;23:483–488
  51. Pearson HA, Johnston D, Smith KA, Touloukian RJ. The born-again spleen (Return of splenic function after splenectomy for trauma). N Engl J Med. 1978;298:1389–1392
  52. O'Connor JV, Brown CC, Thomas JK, et al. Thoracic splenosis. Ann Thorac Surg. 1998;66:552–553
  53. Mazur EM, Field WW, Cahow CE, et al. Idiopathic thrombocytopenic purpura occurring in a subject previously splenectomized for traumatic splenic rupture (Role of splenosis in the pathogenesis of thrombocytopenia). Am J Med. 1978;65:843–846
  54. Fleming CR, Dickson ER, Harrison EG. Splenosis auto-transplantation of splenic tissue. Am J Med. 1976;61:414–419

PII: S0002-9343(08)00185-X

doi: 10.1016/j.amjmed.2008.02.014

The American Journal of Medicine
Volume 121, Issue 5 , Pages 371-375 , May 2008

Article Tools