In Reply.—In response to Dr Kiroff's letter, several points can be made.
In our study, patients with natural splenosis did have fewer circulating pitted RBCs when compared with totally asplenic persons. However, this difference was not statistically significant. The small mass of tissue present in patients with splenosis was obviously incapable of removing all damaged RBCs from the circulation.
Further, this study represents one of the largest series of traumatized patients with splenectomy in whom IgM levels were measured and compared with controls. No significant reduction in IgM was noted in these patients.
Regardless of the technique used to measure the presence of natural splenosis, the mass of tissue present is but a fraction of the normal splenic weight. In our own laboratory, rats subjected to splenectomy and intraperitoneal autotransplantation of liquefied splenic material was found after six months to have only small fragments of splenic tissue present.