P T Foley1, H Kavnoudias2, P U Cameron3,4, C Czarnecki5, E Paul6, S M Lyon7,8. 1. Department of Medical Imaging, The Canberra Hospital, Yamba Drive, Garran, ACT, 2605, Australia. pfoley@doctors.org.uk. 2. Radiology Research Unit, Radiology Department, The Alfred Hospital, Commercial Rd, Melbourne, VIC, 3004, Australia. h.kavnoudias@alfred.org.au. 3. Infectious Diseases Unit, The Alfred Hospital, Commercial Rd, Melbourne, VIC, 3004, Australia. paul.cameron@unimelb.edu.au. 4. Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, 792 Elizabeth St, Melbourne, VIC, 3000, Australia. paul.cameron@unimelb.edu.au. 5. Radiology Department, Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia. caroline.czarnecki@gmail.com. 6. Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, Commercial Rd, Melbourne, VIC, 3004, Australia. eldho.paul@monash.edu. 7. Melbourne Endovascular, 5 Chesterville Rd, Cheltenham, VIC, 3192, Australia. lyonsey@optusnet.com.au. 8. Radiology Department, The Alfred Hospital, Commercial Rd, Melbourne, VIC, 3004, Australia. lyonsey@optusnet.com.au.
Abstract
PURPOSE: To compare the impact of proximal or distal splenic artery embolisation versus that of splenectomy on splenic immune function as measured by IgM memory B cell levels. MATERIALS AND METHODS: Patients with splenic trauma who were treated by splenic artery embolisation (SAE) were enrolled. After 6 months splenic volume was assessed by CT, and IgM memory B cells in peripheral blood were measured and compared to a local normal reference population and to a post-splenectomy population. RESULTS: Of the 71 patients who underwent embolisation, 38 underwent proximal embolisation, 11 underwent distal embolisation, 22 patients were excluded, 1 had both proximal and distal embolisation, 5 did not survive and 16 did not return for evaluation. There was a significant difference between splenectomy and proximal or distal embolisation and a trend towards greater preservation of IgM memory B cell number in those with distal embolisation-a difference that could not be attributed to differences in age, grade of injury or residual splenic volume. CONCLUSION: IgM memory B cell levels are significantly higher in those treated with SAE compared to splenectomy. Our data provide evidence that splenic embolisation should reduce immunological complications of spleen trauma and suggest that distal embolisation may maintain better function.
PURPOSE: To compare the impact of proximal or distal splenic artery embolisation versus that of splenectomy on splenic immune function as measured by IgM memory B cell levels. MATERIALS AND METHODS:Patients with splenic trauma who were treated by splenic artery embolisation (SAE) were enrolled. After 6 months splenic volume was assessed by CT, and IgM memory B cells in peripheral blood were measured and compared to a local normal reference population and to a post-splenectomy population. RESULTS: Of the 71 patients who underwent embolisation, 38 underwent proximal embolisation, 11 underwent distal embolisation, 22 patients were excluded, 1 had both proximal and distal embolisation, 5 did not survive and 16 did not return for evaluation. There was a significant difference between splenectomy and proximal or distal embolisation and a trend towards greater preservation of IgM memory B cell number in those with distal embolisation-a difference that could not be attributed to differences in age, grade of injury or residual splenic volume. CONCLUSION: IgM memory B cell levels are significantly higher in those treated with SAE compared to splenectomy. Our data provide evidence that splenic embolisation should reduce immunological complications of spleen trauma and suggest that distal embolisation may maintain better function.
Entities:
Keywords:
IgM memory B cells; Splenic artery embolisation; Trauma
Authors: Matthew Lukies; Helen Kavnoudias; Adil Zia; Robin Lee; Julian J Bosco; Tim Joseph; Warren Clements Journal: Cardiovasc Intervent Radiol Date: 2020-09-01 Impact factor: 2.740
Authors: Mauro Podda; Belinda De Simone; Marco Ceresoli; Francesco Virdis; Francesco Favi; Johannes Wiik Larsen; Federico Coccolini; Massimo Sartelli; Nikolaos Pararas; Solomon Gurmu Beka; Luigi Bonavina; Raffaele Bova; Adolfo Pisanu; Fikri Abu-Zidan; Zsolt Balogh; Osvaldo Chiara; Imtiaz Wani; Philip Stahel; Salomone Di Saverio; Thomas Scalea; Kjetil Soreide; Boris Sakakushev; Francesco Amico; Costanza Martino; Andreas Hecker; Nicola de'Angelis; Mircea Chirica; Joseph Galante; Andrew Kirkpatrick; Emmanouil Pikoulis; Yoram Kluger; Denis Bensard; Luca Ansaloni; Gustavo Fraga; Ian Civil; Giovanni Domenico Tebala; Isidoro Di Carlo; Yunfeng Cui; Raul Coimbra; Vanni Agnoletti; Ibrahima Sall; Edward Tan; Edoardo Picetti; Andrey Litvin; Dimitrios Damaskos; Kenji Inaba; Jeffrey Leung; Ronald Maier; Walt Biffl; Ari Leppaniemi; Ernest Moore; Kurinchi Gurusamy; Fausto Catena Journal: World J Emerg Surg Date: 2022-10-12 Impact factor: 8.165