Splenic autotransplantation provides protection against fatal sepsis in young but not in old rats.

Splenectomy increases the risk of contracting infections with high mortality. Thus, splenic tissue should be repaired orthotopically whenever possible. If all attempts fail, splenic autotransplantation might be a suitable method for splenic salvage. The protective function of such transplants in adults has been questioned, leading to a decreased frequency of splenic autotransplantations. However, the regeneration of splenic tissue is better in the young organism than in the old, suggesting that the protection provided by regenerated splenic tissue might be more reliable in children than in adults. In addition, children are at a higher risk in the case of overwhelming postsplenectomy sepsis. The protection warranted by regenerated splenic tissue after autotransplantation at different ages was examined using a highly standardized animal model. Sham operation, splenectomy, and splenic autotransplantation were performed on adult, weanling, and newborn rats, and Streptococcus pneumoniae was applied intranasally 9 months after the operation. After pneumococcal challenge about 80% of the splenectomized animals in the different age groups died of infection, whereas only 20% of the sham operated rats died. Regenerated splenic tissue resulting from splenic autotransplantation performed on adult or weanling rats demonstrated no protective function. However, in newborn rats with transplanted splenic tissue, both survival rate and survival time were increased significantly. Determination of lymphocyte subsets in the blood did not allow the protective role of splenic transplants to be predicted. This study indicates that disappointing results of splenic autotransplantation in adult patients should not lead to false pessimism about the role of this operation in children.

The in vitro lymphocyte/endothelium binding assay. An improved method employing light microscopy.

The in vitro lymphocyte binding assay (HEV assay) has proved to be a useful approach for examining the first step of lymphocyte migration, i.e., homing to organs containing high endothelial venules (HEVs). Since fluorescence-labelled standard lymphocytes are usually included in each assay to account for day-to-day variations, HEV preparations have to be evaluated by fluorescence microscopy. Thus no counterstaining can be performed and HEVs without adherent lymphocytes cannot easily be recognized. Because the preparations are not suitable for storage they must be evaluated within a short time. In this study an improved technique is described which permits HEV preparations made with fluorescence-labelled standard lymphocytes to be evaluated by light microscopy in counterstained sections. The phenotypes of the sample lymphocytes can be determined by staining for surface antigens on the same slides and the preparations obtained are permanent.

Absolute numbers of lymphocytes subsets migrating through the compartments of the normal and transplanted rat spleen.

Lymphocyte migration is one of the basic principles of the immune system. Up to now lymphocyte migration experiments have been performed either in a quantitative way, determining whole organ recoveries of radiolabeled lymphocytes without histologic localization, or based on autoradiography which does not provide absolute numbers of immigrant lymphocytes. In this study the traffic of lymphocyte subsets through the splenic compartments: red pulp (RP), marginal zone (MZ), periarteriolar lymphatic sheath (PALS) and follicle was evaluated in absolute numbers. In normal spleens and splenic transplants fluorescein isothiocyanate (FITC)-labeled immigrant lymphocytes were localized and characterized immunohistochemically in cryostat sections by light microscopy. In addition morphometry of the splenic compartments was performed and the recovery of 51Cr-labeled lymphocytes in the spleen was determined. The combination of these methods allowed total numbers of immigrant subset cells to be calculated in individual splenic compartments. At 15 min about 17% of the injected B lymphocytes were found in the MZ. This is the largest fraction of an injected lymphocyte subset found in a single splenic compartment. At 24 h immigrant B cells were not only found in the follicle, but they had reached comparable numbers in the three compartments: follicle, RP and MZ. Most immigrant T lymphocytes were found in the PALS, which from 6 h after injection onwards contained more T cell immigrants than any single organ of the body. CD4+ and CD8+ lymphocytes showed a similar distribution throughout the splenic compartments at early time points. At 24 h CD4+ lymphocytes homed preferentially to the PALS, whereas CD8+ cells seemed to prefer the RP and MZ. Both CD4+ and CD8+ cells also migrated into the follicles. In regenerated splenic tissue after autotransplantation lymphocyte immigration was reduced in all compartments and to the MZ in particular. An impaired lymphocyte migration to the MZ in splenic transplants may be one reason for the lack of protection provided against bacterial infections. Thus examining lymphocyte migration in absolute numbers provides additional information which cannot be gained by determining labeling indices or percentages of lymphocyte subsets alone.

Immunohistological localization and characterization of FITC-labelled lymphocytes. A rapid and inexpensive method for studying migration.

Immunohistochemical methods are described for the detection and characterization of fluorescein isothiocyanate (FITC)-labelled lymphocytes on cryostat sections using an anti-FITC antibody. As a model, the localization of thoracic duct lymphocytes (TDL) in the rat spleen was examined at three time intervals. The kinetic patterns observed clearly differed between the four splenic compartments examined, namely: the red pulp, the marginal zone, the periarteriolar lymphatic sheath (PALS) and the follicle. Furthermore, the subset composition of the immigrant lymphocytes was determined by two colour immunohistochemical staining, which permitted simultaneous detection of the FITC label and surface markers. The results suggest that this method is a fast, easy and inexpensive approach to studies of lymphocyte migration.

Migration pattern of lymphocyte subsets in the normal rat and the influence of splenic tissue.

Lymphocyte subsets leave the blood and appear in the thoracic duct of normal rats at different rates. The aim of the present study was to investigate their migration pattern through blood, spleen, bone marrow, mesenteric lymph nodes, and Peyer's patches in normal Lewis rats and to study the role of the spleen using splenectomized and spleen-transplanted animals. Fluorescein isothiocyanate (FITC)-labelled thoracic duct lymphocytes (TDL) were injected intravenously into rats and after 15 min, 1, 6, and 24 h the percentages of B, T, T helper (TH) and T-cytotoxic/suppressor (TC/S) lymphocytes in the FITC+ cells were determined in cell suspensions by means of monoclonal antibodies. B and T lymphocytes are preferentially localized in different organs, e.g. B cells in Peyer's patches and T cells in mesenteric lymph nodes. The migration of TH lymphocytes differed from that of TC/S lymphocytes in all the organs investigated. In the late phase after injection the migration of B and TH lymphocytes was influenced by the spleen, since after splenectomy the number of injected B lymphocytes increased and that of TH lymphocytes decreased in all organs investigated except the bone marrow. Splenic autotransplantation could not normalize the disturbed migration.

Influence of donor and host age on the regeneration and blood flow of splenic transplants.

After splenectomy there is an increased risk of fatal overwhelming postsplenectomy sepsis, especially in children. If all alternatives to splenectomy fail, autotransplantation of splenic fragments is indicated. These fragments regenerate after a necrotic phase to small splenic nodules. Regulatory factors governing the regeneration process are largely unknown. Inbred rats were used as a model to define the influence of recipient and donor age on the regenerated mass and the blood flow of transplanted splenic fragments. These are both important factors for the protective function of the spleen. Fetal, newborn, weanling, or adult spleens were implanted into the greater omentum of newborn, weanling, or adult rats. The younger the recipient and donor, the better the regeneration and perfusion of transplants. However, these did not reach more than 40% of the normal splenic mass. In addition, no experimental group achieved more than one third of the normal splenic blood flow. There is an obvious age dependency in splenic regeneration and blood flow, but the transplants are far from attaining a normal splenic mass and perfusion.