Auto
transplantation of the spleen can be performed in the patients with traumatic
rupture of the spleen, in whom spleen could not be conserved in the other way. The right indication for this method is isolated
rupture of the spleen (concvasation or complete devascularisation). This method is not recommended in the endangered patients, patients with previous disease of the spleen as well as in the patients with the perforation of the other abdominal organs at the same time. Auto
transplantation was performed in 12 patients with isolated
splenic rupture and hematoperitoneum, 11 men and one woman. The majority of patients are younger. In 8 patients, autotransplant was placed into big omentum, in three into lipomatous tissue surrounding left kidney, and in one into anterior abdominal wall. In all the patients from this group, following analysis were taken: MCV (middle volume of erythrocytes), HTC, Hb, Le,
Glucose,
urea, creatinin,
sodium,
potassium,
alkali phosphatasis, target cells, Howell Jolly's bodies, Heinz's bodies,
IgG,
IgA,
IgM, C3, C4, T3, T4, T8, B, segmentated, eosinophiles, lymphocytes, reticulocytes, thrombocytes,
fibrinogen, PT, APTT, aggregation of thrombocytes and aggregation of thrombocytes on
collagen. The same parameters were taken in 12 patients with surgery similar to
splenectomy and in 12 after
splenectomy. After
splenectomy, there was decrease of the immunologic defending abilities of the organism because of the loss of the childrens function of the spleen, decreased level of the opsonines and tutsin, which leads to the impaired phagocytosis, decreased concentration of
IgM and T and B lymphocytes, while in patients after auto
transplantation the results were physiological. The most important thing in the assessment of the function of the autotransplanted spleen is scintigraphic investigation using 99mTc-denaturated red blood cells. In our study, auto transplant function was assessed in 10/12 patients by scintigraphy. Five years after surgery, no one patient was proved to have postsplenectomic
sepsis.