Inclusion of Spleen in Pediatric Multivisceral Transplantation

T. Kato, G. Kleiner, A. David, G. Selvaggi, S. Nishida, J. Madariaga, John F. Thompson, P. Ruiz, A. Tzakis

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Inclusion of the donor spleen may be beneficial for small children who receive multivisceral transplantation (MVT) because asplenia is associated with increased risk of bacterial sepsis. Beginning in 2003, the spleen was transplanted together with multivisceral transplantation in 17 children under daclizumab induction (spleen group). The results were compared to 23 children who received multivisceral transplantation without the spleen (control group) with the same immunosuppression regimen. Median age of 17 patients who received a spleen was 0.80 years (range 0.54-1.66). Platelet counts at 30 and 60 days posttransplant were significantly lower in the spleen group (average values: day 30: 399,000 vs 636,000, P = .015; day 60: 413,000 vs 622,000, P = .0056). WBC counts at 30 and 60 days posttransplant were also decreased in the spleen group but the difference was not statistically significant. Median rejection-free survival was 205 days in the spleen group and 101 days in the control group (P = NS). Median length of hospital stay was 39 days in the spleen group and 61 days in the control group. With a median follow-up of 398 days (spleen group) and 1232 days (control group), 3 of 17 (17%) in the spleen group developed graft versus host disease (GVHD), whereas 1 of 23 (4.5%) in control group did (P = NS). In one patient in each group, GVHD was fatal. No patient developed posttransplant lymphoproliferative disorder (PTLD) in the spleen group, whereas 4 of 23 (17%) in the control group developed PTLD. One-year patient survival was 84% in the spleen group and 86% in the control group. Recipients of the spleen as part of a multivisceral graft had significantly lower platelet counts. Rejection-free survival may be prolonged, but the risk of GVHD may be increased.

Original languageEnglish (US)
Pages (from-to)1709-1710
Number of pages2
JournalTransplantation Proceedings
Volume38
Issue number6
DOIs
StatePublished - Jul 2006
Externally publishedYes

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Spleen
Transplantation
Pediatrics
Control Groups
Graft vs Host Disease
Lymphoproliferative Disorders
Platelet Count
Survival
Length of Stay
Immunosuppression
Sepsis
Tissue Donors
Transplants

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Kato, T., Kleiner, G., David, A., Selvaggi, G., Nishida, S., Madariaga, J., ... Tzakis, A. (2006). Inclusion of Spleen in Pediatric Multivisceral Transplantation. Transplantation Proceedings, 38(6), 1709-1710. https://doi.org/10.1016/j.transproceed.2006.05.059

Inclusion of Spleen in Pediatric Multivisceral Transplantation. / Kato, T.; Kleiner, G.; David, A.; Selvaggi, G.; Nishida, S.; Madariaga, J.; Thompson, John F.; Ruiz, P.; Tzakis, A.

In: Transplantation Proceedings, Vol. 38, No. 6, 07.2006, p. 1709-1710.

Research output: Contribution to journalArticle

Kato, T, Kleiner, G, David, A, Selvaggi, G, Nishida, S, Madariaga, J, Thompson, JF, Ruiz, P & Tzakis, A 2006, 'Inclusion of Spleen in Pediatric Multivisceral Transplantation', Transplantation Proceedings, vol. 38, no. 6, pp. 1709-1710. https://doi.org/10.1016/j.transproceed.2006.05.059
Kato T, Kleiner G, David A, Selvaggi G, Nishida S, Madariaga J et al. Inclusion of Spleen in Pediatric Multivisceral Transplantation. Transplantation Proceedings. 2006 Jul;38(6):1709-1710. https://doi.org/10.1016/j.transproceed.2006.05.059
Kato, T. ; Kleiner, G. ; David, A. ; Selvaggi, G. ; Nishida, S. ; Madariaga, J. ; Thompson, John F. ; Ruiz, P. ; Tzakis, A. / Inclusion of Spleen in Pediatric Multivisceral Transplantation. In: Transplantation Proceedings. 2006 ; Vol. 38, No. 6. pp. 1709-1710.
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abstract = "Inclusion of the donor spleen may be beneficial for small children who receive multivisceral transplantation (MVT) because asplenia is associated with increased risk of bacterial sepsis. Beginning in 2003, the spleen was transplanted together with multivisceral transplantation in 17 children under daclizumab induction (spleen group). The results were compared to 23 children who received multivisceral transplantation without the spleen (control group) with the same immunosuppression regimen. Median age of 17 patients who received a spleen was 0.80 years (range 0.54-1.66). Platelet counts at 30 and 60 days posttransplant were significantly lower in the spleen group (average values: day 30: 399,000 vs 636,000, P = .015; day 60: 413,000 vs 622,000, P = .0056). WBC counts at 30 and 60 days posttransplant were also decreased in the spleen group but the difference was not statistically significant. Median rejection-free survival was 205 days in the spleen group and 101 days in the control group (P = NS). Median length of hospital stay was 39 days in the spleen group and 61 days in the control group. With a median follow-up of 398 days (spleen group) and 1232 days (control group), 3 of 17 (17{\%}) in the spleen group developed graft versus host disease (GVHD), whereas 1 of 23 (4.5{\%}) in control group did (P = NS). In one patient in each group, GVHD was fatal. No patient developed posttransplant lymphoproliferative disorder (PTLD) in the spleen group, whereas 4 of 23 (17{\%}) in the control group developed PTLD. One-year patient survival was 84{\%} in the spleen group and 86{\%} in the control group. Recipients of the spleen as part of a multivisceral graft had significantly lower platelet counts. Rejection-free survival may be prolonged, but the risk of GVHD may be increased.",
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