Splenectomy and Death in Renal Transplant Patients

Thomas G. Peters, MD; James W. Williams, MD; Harvey C. Harmon, MD; Louis G. Britt, MD
Arch Surg. 1983;118(7):795-799. doi:10.1001/archsurg.1983.01390070007002.
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• To determine any association of splenectomy and death, 191 recipients of a single renal transplant were reviewed. Pretransplant splenectomy was performed in 90(47%) patients and the spleen was retained ("spleen-retaining") in 101 (53%). Sixty-eight patients (36%) died. Thirty-two fatal infections occurred in asplenic patients compared with ten infection-caused deaths in those retaining the spleen; 12 asplenic and 14 spleen-retaining patients died of noninfectious causes. Age, sex, graft source, HLA mismatch, and period of graft function were similar in asplenic and spleen-retaining patients who died. Prospective, multicenter, and single-center studies support divergent conclusions regarding the risks and benefits of splenectomy in transplantation. Study of specific center experience should precede adopting a policy of pretransplant splenectomy, an irreversible form of immunosuppression significantly related to fatal infection.

(Arch Surg 1983;118:795-799)


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