Failure of splenic implants to protect against fatal postsplenectomy infection.

Overwhelming postsplenectomy infection is not a phenomenon confined to children. In all age groups, splenic trauma that requires surgery should be managed by splenorrhaphy if possible. Autoimplantation of splenic fragments into omental pockets has been performed in the few patients we have seen who required splenectomy. A case has been presented in which these small implants failed to protect a 61 year old woman from the development of fatal pneumococcal sepsis. The patient had received a pneumococcal vaccination, and her implants had shown activity on radionuclide scanning. Concerns about critical splenic mass, blood supply to the implant, and hepatic function require further study before this technique can be considered efficacious.