Spleen Transplant
This is the transfer of the spleen or its fragments from one individual to another. This procedure, however, is still under research. It is being examined for immunological tolerance induction in the research subjects. It is also worth noting that the success of this procedure has been achieved in rats and, more recently, in pigs. Read More
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Spleen Transplant
Understanding the reasons for a spleen transplant and everything involved might be tasking, so let’s first start with understanding the organ called the spleen.
Table of contents
What is a spleen?
The spleen is an organ in the abdominal cavity located just above the stomach on the left side of the body. It is a lymphatic organ, and it also stores and filters blood.
What is the function of the spleen?
The spleen is a vital organ in the human body; it has several functions, which include:
- Blood storing
- Blood filtering
- Destruction of old and damaged blood cells
- Production of white blood cells
- Maintaining fluid levels in the body
- Production of antibodies
What is the anatomy of the spleen?
The spleen is made up of two main parts, with each of the parts having a different section and function. These parts include
- White pulp – this is the part of the spleen responsible for its immune function; it is involved in white blood cell production. These white blood cells then produce antibodies that help to fight infections in the body.
- Red pulp – the red pulp is involved in the filtering of blood. It is also involved in the destruction of worn-out and damaged red blood cells. It also destroys viruses and bacteria.
What is Splenectomy?
This is the surgical removal of the spleen. The most common reason for splenectomy is a spleen rupture, which is usually caused by abdominal trauma or injury. The surgical procedure, however, can be employed to treat a number of other issues. Splenectomy can be carried out through laparoscopy, which is performed with a tiny camera and some special surgery tools.
When only a part of the spleen is removed, it is called a partial splenectomy. The spleen does not regenerate after it has been removed. There is a structure called the accessory spleen in 30% of humans. In the incidence of splenectomy in these individuals, they may grow and function as the spleen. Sometimes a piece of the spleen may be separated following a trauma to the organ; that piece may then take over the functions in the case of splenectomy.
What are the reasons for splenectomy?
Splenectomy may be recommended for a variety of diseases and conditions and include
- Rupture – this is caused by different issues such as trauma, infarction, etc. it may lead to internal bleeding, which is life-threatening. due
- Infections – abscesses on the spleen may lead to splenectomy when it does not respond to other treatments.
- Cancer – some cancers that can be treated with splenectomy include lymphocytic leukemia, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, etc.
- Blood disorders – these include idiopathic thrombocytopenia purpura, thalassemia, etc.
- Tumors or cysts- these can require splenectomy when they increase in size and become massive.
- Splenomegaly – this could be used as a treatment for this condition, especially if it is from unknown causes.
- Splenic infarction – blocking of arteries feeding the spleen, usually by clots, may lead to the rupture of the spleen, which then requires splenectomy.
Surgical procedure
This can be done either as a minimally invasive or open surgery procedure. The method chosen often depends on the size of the spleen.
- Laparoscopic splenectomy – In this procedure, incisions are made on the abdomen, then a tube with a tiny camera is inserted into the abdomen. This camera is used to monitor as other special surgical tools inserted in other incisions are used to remove the spleen. Then after, the incisions are closed. This procedure is inappropriate for all conditions; however, a ruptured spleen requires an open splenectomy.
- Open splenectomy – an incision is made in the middle of the abdomen, and muscles and tissues are moved to locate the spleen. The spleen is then removed, and the incision is closed.
What is a Spleen Transplant?
Spleen transplant or transplantation is the transfer of the spleen or its fragments from one individual to another. It involves replacing a damaged or diseased spleen with a healthy one from a donor. This procedure, however, is still under research. It is very rare compared to other organ transplants. This rarity is partly because the body can often manage without a spleen. It is being examined for immunological tolerance induction in the research subjects. It is also worth noting that the success of this procedure has been achieved in rats and, more recently, in pigs.
The procedure has also been performed on human beings but the results gotten have been varied. In other research, results indicate that embryonic pig spleen transplants may work in humans. This can remedy conditions in patients with genetic deficiencies like hemophilia, phenylketonuria, or other disorders. The greatest challenge to the procedure’s adaptation is the immunosuppressive medication required to avoid host rejection of these tissues, as this therapy carries its inherent risks. So the procedure is only advocated in situations where no other solution is available.
A 2020 review of 18 experimental studies found that the transplanted spleen appears functional. There was 95% regeneration, 90% normalized blood film, and restoration of antibody levels (1).
Why Might Someone Need a Spleen Transplant?
Several conditions and circumstances might necessitate a spleen transplant:
- Sickle Cell Disease: This genetic disorder causes red blood cells to deform, leading to various complications. A spleen transplant can alleviate some symptoms and improve life quality.
- Trauma: Severe abdominal injuries can damage the spleen beyond repair. In such cases, a transplant may be the best solution.
- Cancer: Certain cancers, such as lymphoma, can affect the spleen. If the cancer is localized to the spleen, a transplant may be necessary.
- Autoimmune Diseases: Conditions like idiopathic thrombocytopenic purpura (ITP) can cause the spleen to destroy platelets. A spleen transplant can help in managing such diseases.
- Inherited Metabolic Disorders: Diseases like Gaucher’s disease affect the spleen and other organs. A transplant can help in managing these conditions effectively.
Can You Get a Spleen Transplant?
Yes, you can get a spleen transplant, but it is not common. The procedure is complex and requires a suitable donor. The donor spleen must be a good match for the recipient to minimize the risk of rejection. The scarcity of suitable donors and the complexity of the surgery make spleen transplantation rare. Post-surgery complications have been recorded in most patients.
The Spleen Transplant Procedure
A spleen transplant is a major surgical procedure that involves several critical steps:
- Evaluation and Preparation: Before the surgery, the patient undergoes a thorough evaluation. This includes blood tests, imaging studies, and assessments by various specialists. The goal is to ensure the patient is healthy enough for the surgery and to find a compatible donor.
- Finding a Donor: The donor can be a living donor or a deceased donor. The donor’s spleen must match the recipient’s tissue type to reduce the risk of rejection.
- Surgery: The surgery is performed under general anesthesia. The damaged spleen is removed, and the donor spleen is implanted. Surgeons carefully connect blood vessels to ensure the new spleen has an adequate blood supply.
- Post-Surgery Care: After the surgery, the patient is closely monitored in the hospital. This includes checking for signs of rejection, infection, and ensuring the new spleen functions correctly.
Risks and Complications
Like any major surgery, spleen transplantation carries risks. These include:
- Rejection: The body’s immune system may recognize the new spleen as foreign and attack it. Medications called immunosuppressants are given to prevent this.
- Infection: Without a spleen or with a newly transplanted spleen, the patient is at higher risk for infections. Vaccinations and antibiotics are used to mitigate this risk.
- Bleeding: As the spleen is involved in blood filtration, surgery can lead to significant bleeding.
- Blood Clots: There is a risk of blood clots forming in the blood vessels connected to the new spleen.
Recovery and Life After a Spleen Transplant
Recovery from a spleen transplant can take several months. The patient needs to follow a strict regimen of medications and regular check-ups. Here’s what to expect during recovery:
- Medications: The patient will need to take immunosuppressant medications to prevent rejection. These drugs are usually required for the rest of the patient’s life.
- Follow-Up Appointments: Regular follow-up visits with the transplant team are crucial. These appointments monitor the function of the new spleen and overall health.
- Lifestyle Adjustments: The patient may need to make lifestyle changes to reduce the risk of infection and maintain overall health. This includes maintaining a balanced diet, avoiding exposure to infections. They should also, adhering to a regular exercise routine.
- Vaccinations: Patients without a functioning spleen or with a newly transplanted spleen need to stay up-to-date on vaccinations. This is vital to protect against infections.
The Importance of Medical Support
Continuous medical support is essential for spleen transplant patients. This support includes regular blood tests, imaging studies, and consultations with various specialists. The healthcare team will work closely with the patient to ensure the new spleen functions correctly and to manage any complications that arise. So far, complications have been recorded in most human patients after spleen transplantation.
Conclusion
Spleen transplantation is a life-saving procedure for those with severe spleen-related conditions. While it is not a common surgery, it offers hope to patients with sickle cell disease, severe trauma, cancer, autoimmune diseases, and inherited metabolic disorders. Understanding the procedure, risks, and recovery process is important for anyone considering or preparing for a spleen transplant.
FAQ
Some of the complications that can be experienced in this surgery include bleeding, infections, blood clots, and injury to the surrounding abdominal organs like the pancreas, colon, and stomach.
An individual is more likely to contract severe infections after splenectomy. Usually, a series of vaccinations is recommended after the surgery. Vaccines against pneumonia, Haemophilus, meningococci, etc., are usually prescribed. Preventive antibiotics are also recommended, especially in the instance of other ongoing severe conditions.
Without complications, the patient is usually discharged after two days of the laparoscopic procedure or five to seven years of an open procedure. The other body organs take over the functions previously performed by the spleen. There is also an increased risk of sickness and serious infections following splenectomy. The healthcare provider should be notified if any of the following signs of infections are noticed
1) A fever of 38 degrees or higher
2) Redness or tenderness on any part of the body
3) Sore throat
4) Chills
5) Colds lasting unusually long.
A sign indicating that the individual does not have a spleen is also recommended.
It is possible because spleen transplantation is a viable option due to advancements in medical science and healthcare professionals’ dedication. Research is ongoing to induce immunological tolerance in subjects. So far, some success has been recorded in rats and pigs.
References
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