The role of splenectomy in the prevention and treatment of small-for-size syndrome.

Objective To explore the pathophysiologic mechanism of the development of a small-for-size syndrome(SFSS)and the role of splenectomy in the prevention and treatment of SFSS.Methods The rat models of sham-operation and 80% partial hepatectomy were established.Totally 144 rats were randomly divided into 3 groups:1) splenectomy group:splenectomy was performed following 80% partial hepatectomy;2)control group:80% partial hepatectomy was performed;3)sham group:no hepatectomy was performed.After the operation, we examined the portal venous pressures(PVP),tumor necrosis factor(TNF-α)and proliferating cell nuclear antigen(PCNA)expression, the activity of myeloperoxidase(MPO),liver function and explored the prevalence of SFSS.Results Compared with the sham group,the PVP of the rats in the control group obviously elevated after hepatectomy,and the expression level of TNF-α and the activity of MPO in the liver significantly increased(P 0.05).Compared with the control group,the PVP,the expression of TNF-α in the livers and the activity of MPO at the corresponding time points after hepatectomy in the splenectomy group significantly decreased,while the expression of PCNA increased(P 0.05).Administration of splenectomy resulted in a statistically significant decrease in aspartate transaminase(AST),alanine transaminase(ALT),lactate dehydrogenase(LDH),total bilirubin,and the incidence of SFSS(P 0.05).Conclusion Splenectomy could alleviate liver injury,promote liver regeneration in small-for-size liver rats by reducing portal vein perfusion and pressure and the subsequent expression of proinflammatory mediators.