Circulating cellular and humoral elements of immune function following splenic arterial embolisation or splenectomy in trauma patients.

Abstract

Splenectomy impairs the ability to combat infection, especially with encapsulated organisms. However, there is limited understanding of the impact of splenic arterial embolisation on immune function. Our hypothesis was that embolisation would not impair systemic immune function. This study examines elements of cellular and humoral immunity in patients undergoing splenic embolisation or splenectomy for trauma. Splenic embolisation (SE) and splenectomy patients (S) were compared to blunt trauma patients without splenic injury (NS). Lymphocyte counts, natural-killer cells, serum complement (C3, C4), and properdin levels were assayed. No significant differences in total, helper, or suppressor T-lymphocytes, complement (C3, C4), or properdin were found. B-lymphocyte counts were higher in S (602±445cells/mm(3)) than SE (238±114cells/mm(3)) or NS (293±153cells/mm(3)) (p=.003 for pairwise comparisons). S also had more natural killer T-cells than NS (325±170cells/mm(3) vs. 174±116cells/mm(3), p=.004). Splenic embolisation does not alter the measured immunologic parameters. The absence of sensitive markers for splenic immune function limits the ability to assess the impact of embolisation for trauma.