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Exogenous and endogenous angiogenic stimuli do not augment splenic autotransplantation
Richard E Power1, Elaine W Kay, David Bouchier-Hayes
1Department of Surgery, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin.
Objective:
To find out if angiogenic stimulation improves the ability of the spleen to regenerate.
Design:
Experimental study.
Setting:
Teaching hospital, Republic of Ireland.
Animals:
27 male Sprague-Dawley rats.
Interventions:
Each spleen was removed and half was reimplanted in the greater omentum. The rats were randomised into three groups of 9 each: the first (control) group was given no stimulation; the second had the implanted spleen sutured into the omentum with 6/0 polypropylene; and in the third group the implanted spleen was injected with human recombinant vascular endothelial growth factor (VEGF) 500 microg.
Main Outcome Measures:
Clearance of Howell-Jolly bodies, and the weight and histological appearance of the splenic remnant at 3 months.
Results:
The splenic remnant was significantly larger at 3 months in the control group (p = 0.0006). Histological examination of the tissue from the control group showed that it was architecturally similar to that of normal functioning spleen, whereas the tissue from the two treated groups contained less lymphoid tissue and showed widespread acute and chronic inflammatory changes. There was a significantly greater clearance of Howell-Jolly bodies (an index of splenic function) from the peripheral blood of the control group (p = 0.0009).
Conclusion:
The excellent recovery of the splenic remnant in the control group suggests that the procedure of splenic autotransplantation might warrant further consideration and study.