Role of splenectomy in human liver transplantation under modern-day immunosuppression.

Published

Journal Article

Between January 1987 and October 1991, 1466 patients underwent consecutive Orthotopic Liver Transplantation (OLTx) at the University of Pittsburgh. Forty of these patient's had concomitant splenectomy with OLTx. These patients were compared to 147 randomly selected OLTx patients without splenectomy within the same time period. One-year patient and graft survival (PS and GS) were lower in splenectomized (Splx) patients compared to nonsplenectomized (non-Splx) patients (59% vs 86% PS, 55% vs 80% GS, respectively). One-month and one-year patient mortality in the Splx group was higher than in the non-splx patients (20% vs 3.4%, P < 0.001 for one month; 40% vs 14.3%, P = 0.003 for one year, respectively). One-month and one-year sepsis-related mortality was also high in Splx patients (17.5% vs 2.7%, P = 0.0022, for one month, and 30% vs 11.5%, P = 0.0043, for one year, respectively). We conclude that concomitant splenectomy with OLTx has a significantly higher patient mortality mainly due to its septic complications and, at present, unless there is a specific indication for a splenectomy, the routine addition of this procedure to liver allograft surgery would not be recommended.

Full Text

Duke Authors

Cited Authors

  • Samimi, F; Irish, WD; Eghtesad, B; Demetris, AJ; Starzl, TE; Fung, JJ

Published Date

  • September 1998

Published In

Volume / Issue

  • 43 / 9

Start / End Page

  • 1931 - 1937

PubMed ID

  • 9753254

Pubmed Central ID

  • 9753254

International Standard Serial Number (ISSN)

  • 0163-2116

Digital Object Identifier (DOI)

  • 10.1023/a:1018822206580

Language

  • eng

Conference Location

  • United States