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

Samimi, F and Irish, WD and Eghtesad, B and Demetris, AJ and Starzl, TE and Fung, JJ (1998) Role of splenectomy in human liver transplantation under modern-day immunosuppression. Digestive Diseases and Sciences, 43 (9). 1931 - 1937. ISSN 0163-2116

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Abstract

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.

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Details

Item Type:	Article
Status:	Published
Creators/Authors:	Creators Email Pitt Username ORCID Samimi, F Irish, WD Eghtesad, B Demetris, AJ Starzl, TE tes11@pitt.edu TES11 Fung, JJ
Centers:	Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date:	5 October 1998
Date Type:	Publication
Journal or Publication Title:	Digestive Diseases and Sciences
Volume:	43
Number:	9
Page Range:	1931 - 1937
DOI or Unique Handle:	10.1023/a:1018822206580
Institution:	University of Pittsburgh
Refereed:	Yes
ISSN:	0163-2116
Other ID:	uls-drl:31735062127737, Starzl CV No. 2052
Date Deposited:	08 Apr 2010 17:35
Last Modified:	27 Jan 2019 02:55
URI:	http://d-scholarship.pitt.edu/id/eprint/5438

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