Influence of splenectomy in patients with liver cirrhosis and hypersplenism.

Abstract

AIM:

Splenectomy improves hypersplenic thrombocytopenia in cirrhotic patients with hypersplenism. However, the long-term influence of splenectomy has not been clarified. We examined whether splenectomy improved liver fibrosis and caused immunological changes.

METHODS:

We collected liver and spleen specimens and peripheral blood (PB) from 26 patients with hepatitis C virus-related liver cirrhosis. An immunohistochemical examination of CD4, CD8, forkhead box P3, granzyme B and transforming growth factor-β1, and Masson-trichrome stain were performed in spleen and liver tissues and in seven cases of follow-up liver biopsy sections obtained after splenectomy. We obtained PB before and at various intervals after splenectomy. We also examined the ratio of CD4(+) and CD8(+) lymphocytes in PB using flow cytometry.

RESULTS:

We observed improvements in liver fibrosis in four biopsy specimens obtained after splenectomy, in which fibrotic areas significantly decreased from 19.5% to 8.2% (P < 0.05). Increases were also observed in the ratio of CD8(+) cells in PB after splenectomy, which resulted in a significant decrease in the CD4(+) /CD8(+) ratio (P < 0.001). The carcinogenic rate in patients with a CD4(+)  : CD8(+) ratio that decreased by more than 0.5 at 1 month after splenectomy was significantly lower than that in patients with a ratio that decreased by less than 0.5 (P < 0.05).

CONCLUSION:

Splenectomy may improve liver fibrosis and cause beneficial immunological changes in cirrhotic patients with hepatitis. Improvements in antitumor mechanisms can be also expected.

• Authors: Yoriko Nomura, Masayoshi Kage, Toshirou Ogata, Reiichirou Kondou, Hisafumi Kinoshita, Kouichi Ohshima, Hirohisa Yano
• Journal: Hepatology research : the official journal of the Japan Society of Hepatology (Hepatol Res) Vol. 44 Issue 10 Pg. E100-9 (Oct 2014) ISSN: 1386-6346 [Print] Netherlands
• PMID: 24033833 (Publication Type: Journal Article)
• Copyright: © 2013 The Japan Society of Hepatology.