Splenic autotransplantation in irreparable splenic injuries, is it functioning or not? [preliminary experience]

ABSTRACT

The spleen is an important organ in the body and its removal may result in serious complications especially in children, so we have to preserve it as much as we can. Splenic autotransplantation has been considered in the instances in which it is impossible to preserve any vascularized fragments or segments of the injuried spleen depending on the fact that sequestrated splenic fragments may survive and function. In this study 20 patients with major splenic injuries presented to the emergency unit, 14 males and 6 females, their age was less than 10 years in 6 patients while in 10 patients their age was ranged from 11 to 30 years and 4 patients were over 30 years. The mode of trauma in all cases was blunt abdominal trauma, Motor vehicle in 12 patients, fall from height in 7 patients and direct blow to the abdomen in one patient. The operative time ranged between 39 to 63 minutes with a mean time of 51 minutes. Our patients were followed up by repeated abdominal ultrasound to assess the maturation of the implanted splenic tissue and to observe occurrence of complications as abscesses at the site of implantation also after a period of 6 weeks postoperatively we assessed the function of the implanted tissue by scintigraphy. The implanted tissue grew and reached different sizes in all patients indicating success of the autotransplantation, also no complications were observed in any patient. In conclusion, splenic autotransplantation is a simple and safe procedure that does not require special skills and should be remembered to preserve the function of the spleen both in adults and children