Intestinal Transplantation: Include the Spleen with Intestinal Graft?

Rei Matsumoto; Tomoaki Kato

doi:10.1016/j.gtc.2023.12.002

Intestinal Transplantation: Include the Spleen with Intestinal Graft?

Gastroenterol Clin North Am. 2024 Jun;53(2):281-288. doi: 10.1016/j.gtc.2023.12.002. Epub 2024 Mar 19.

Authors

Rei Matsumoto¹, Tomoaki Kato²

Affiliations

¹ Center for Liver Disease and Transplantation, Columbia University Irving Medical Center.
² Center for Liver Disease and Transplantation, Columbia University Irving Medical Center. Electronic address: tk2388@columbia.edu.

PMID: 38719378
DOI: 10.1016/j.gtc.2023.12.002

Abstract

The traditional procedure for multivisceral transplant (MVT) is to transplant the stomach, pancreas, intestine, and liver en bloc. During surgery, the native spleen is routinely removed from the recipient, and it usually creates more space in the abdomen to insert the allogeneic graft. Thus, recipients often become asplenic after MVT. Considering all of the risks and benefits, we advocate that temporary transplant of the donor spleen could be the best option for MVT recipients; it could potentially reduce the rate of intestinal allograft rejection without increasing the risk for graft-versus-host disease.

Keywords: Acute cellular rejection; Antibody-mediated rejection; GVHD; Multivisceral transplant; Spleen transplantation; Transplant immunology.

Publication types

Review

MeSH terms

Graft Rejection / prevention & control
Graft vs Host Disease / etiology
Graft vs Host Disease / prevention & control
Humans
Intestines* / transplantation
Organ Transplantation / methods
Pancreas Transplantation / methods
Spleen* / transplantation