SP 8.09 Functional Outcomes of Splenic Autotransplantation Following Splenectomy: A Systematic Review
Basim Busada, Eleanor Van der Zanden, Iliana Bera, Alexander Bull, Goldie Khera, Muhammed SajidAbstract
Aim
Splenectomy is indicated in several clinical conditions, most commonly following trauma. Post-operatively, patients are at risk of developing overwhelming post-splenectomy infection (OPSI), a potentially fatal complication caused by encapsulated bacteria. Splenic autotransplantation has been proposed as a strategy to restore splenic function in patients with otherwise normal splenic tissue. This systematic review aims to evaluate the efficacy and safety of splenic autotransplantation.
Methods
A systematic search of MEDLINE, PubMed, and the Cochrane Library was conducted to identify studies assessing splenic autotransplantation published between January 1947 and January 2026. Data were extracted on study characteristics and outcomes, including postoperative investigations assessing autotransplant viability such as, scintigraphy, contrast-enhanced computed tomography (CECT), peripheral blood film findings (including Howell–Jolly bodies), and serum immunoglobulin (Ig) levels.
Results
Twenty-one primary studies comprising 233 patients were included. Evidence of splenic regeneration on imaging (scintigraphy or CECT) was demonstrated in 96.8% of patients across 19 studies. Among the 13 studies assessing peripheral blood films, 91.6% of patients showed normalization of findings following autotransplantation. In the 12 studies evaluating serum Ig levels, all patients demonstrated postoperative values within normal ranges. Postoperative complications were reported in 8 patients (5%) across 14 studies, while postoperative infection occurred in 1 patient (1.03%) among 8 studies.
Conclusion
Splenic autotransplantation is a safe procedure with minimal complications, restoring splenic function parameters, including imaging evidence of regeneration and normalization of blood films. However, current evidence remains insufficient to demonstrate definitive protection against overwhelming post-splenectomy infection.