[Immunologic alterations after splenectomy for trauma].

Abstract

The effects of splenectomy for trauma patients on immunologic function were studied. Various immunologic indices including humoral and cellular immunity were serially measured up to one year in thirteen adult patients with blunt trauma: All the patients recovered from the initial injury and were good health at 12 month except for one died at ten month from unrelated cause. Complements and immunoglobulins decreased following splenectomy, then rapidly increased to normal or above normal levels and maintained the level throughout the one year period. Contrary to previous reports, Ig-M levels were not decreased after splenectomy. Anti-pneumococcal antibody (Pn-ab) was below effective concentration at one year except one case. Lymphocyte subpopulation was characterized by decreased T (OKT-3) cells and inverted helper/suppressor ratio. Lymphocyte blast formation was suppressed before surgery and remained low throughout the period. This study demonstrated that the humoral immunity was reserved after splenectomy, while cellular immunity such as helper/suppressor ratio and lymphocyte blast formation was impaired even one year after injury in most patients. Increased Ig-M levels after splenectomy in this study might suggest different immune response in Japanese. Decreased Pn-ab would justify the use of anti-pneumococcal vaccine after splenectomy for trauma.