Splenic artery ligation for splenic salvage: clinical experience and immune function

Documentation of overwhelming post-splenectomy sepsis, characterized by infection from encapsulated organisms, has led to development of surgical techniques for preservation of the injured spleen to maintain splenic clearance of encapsulated, opsonized organisms from the circulation. In this study splenic artery ligation (SAL) was performed as an adjunct to successful splenorrhaphy in 20 adults suffering blunt splenic injury. There were no deaths and no reoperations. Twenty units of blood were transfused in ten patients. Splenic removal of blood-borne opsonized particles was measured as the clearance of anti-Rh-antibody-coated 51Cr-radiolabeled autologous red blood cells from the circulation in five SAL patients and nine normal volunteers. The clearance of opsonized red cells 120 minutes after injection was not different (40 +/- 7% of injected dose in controls, 40 +/- 4% in SAL patients). These results demonstrate that SAL can safely be applied as an adjunct to splenorrhaphy and that SAL does not diminish splenic clearance of opsonized particles from the circulation.