Severe sepsis leads to depression of the reticulo-endothelial system (RES) with delayed bloodstream clearance of
particulate matter and bacteria.
Splenectomy results in increased susceptibility to
infection with encapsulated organisms but its effect on the resistance to postoperative Gram-negative
infection has been little studied. We have investigated the effect of
splenectomy on RES function by measurement of plasma
fibronectin concentrations and bacterial clearance in the presence and absence of
sepsis. In experiment 1, rabbits underwent
splenectomy (n = 8) or
laparotomy only (n = 8) 4 weeks before a second
laparotomy. In experiment 2, animals had either
splenectomy (n = 8) or
laparotomy only (n = 8) followed 4 weeks later by devascularization of the appendix (
sepsis). Plasma
fibronectin concentrations and the blood clearance and organ distribution of an
intravenous injection of 75Se-labelled viable Escherichia coli (2-3 X 10(8) colony forming units (c.f.u.] were measured 24 h after the second operation.
Splenectomy resulted in: (1) a persistent reduction in plasma
fibronectin concentration in the presence and absence of
sepsis, and (2) a delay in the bloodstream clearance with reduced hepatic (Kupffer cell) uptake of E. coli which was exaggerated in the septic splenectomized animal. It is concluded that the spleen may be important for Gram-negative bacterial clearance, possibly related to its influence on plasma
fibronectin concentration and Kupffer cell function.