[Autologous replantation of spleen particles--an established procedure? An opinion].

Autologous splenic replantation after splenectomy for trauma is generally recommended in order to prevent postsplenectomy sepsis. Several aspects, however, make this method uncertain: The extent of splenosis induced is not to be predicted. Even if the whole spleen is replanted, the resulting mass may not exceed splenosis, which sometimes develops spontaneously after sole splenectomy. But patients with extended splenic regenerates do not differ from those without any splenosis, considering various immunologic parameters. Postoperative complications after splenic replantation (abscess, intestinal occlusion) are possible, although they may be rare. Fatal cases of postsplenectomy sepsis despite massive splenosis are known. The most important reasons apparently are the altered vascularity and scarring in splenic regenerates. There is no specific test for immunological splenic function. Therefore there is no test to judge the success of replantation, too. Overall, the preservation of the spleen and the vaccination of splenectomized individuals are the most important surgical intentions.