Open AccessMethods of Splenic Preservation and Their Effect on Clearance of Pneumococcal Bacteremia
Author(s) -
Kenneth S. Scher,
Scott-Conner Ce,
Craig Jones,
A F Wroczynski
Publication year - 1985
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198511000-00010
Subject(s) - splenectomy , medicine , spleen , bacteremia , streptococcus pneumoniae , sepsis , gastroenterology , surgery , antibiotics , microbiology and biotechnology , biology
The intravascular clearance of type 3 Streptococcus pneumoniae was studied in Sprague-Dawley rats. Sham celiotomy was performed on 20 animals while another 20 rats underwent splenectomy. Four weeks later, bacteremia was induced by intraperitoneal (IP) injection of S. pneumoniae. Serial cultures of peripheral blood were obtained. Splenectomy produced significant impairment of intravascular clearance of bacteria compared to that noted among control animals (p less than 0.01). Eighty animals were divided into four equal groups: I--splenectomy, II--50% splenectomy with the upper half left in situ connected to the short gastric vessels, III--50% splenectomy with the lower half left in situ connected to the hilar vessels, and IV--splenectomy with implantation of splenic fragments. Pneumococcus was administered IP 16 weeks later. Rats were killed 6 hours after bacterial challenge. Residual splenic tissue was weighed. There was significantly less splenic tissue in Groups II-IV than noted in sham animals after 16 weeks (p less than 0.01). The type of partial splenectomy did not significantly affect the weight of residual splenic tissue 16 weeks later. Implantation did yield viable splenic tissue, though the amount proved significantly less than that resulting from either type of partial splenectomy (p less than 0.01). Mean bacterial counts with time for short gastric (Group II) and hilar (Group III) remnant animals were significantly different from those for the asplenic (Group I) rats (p less than 0.02 and p less than 0.001, respectively). Animals with splenic implants (Group IV) were not significantly different from asplenic rats (Group I). Animals with hilar splenic remnants proved significantly different from those with short gastric splenic remnants (p less than 0.01). Partial splenectomy offers protection against pneumococcal bacteremia, though preservation of the hilar blood supply affords the most benefit. The utility of splenic implantation remains unproven.