Effect of splenectomy on cellular immune function of patients with hepatitis C virus related cirrhotic portal hypertension

Objective To investigate the effect of splenectomy on cellular immune function of patients with hepatitis C virus (HCV) related cirrhotic portal hypertension. Methods Twelve patients with HCV-related cirrhotic portal hypertension undergoing splenectomy + pericardial devascularization in the Second Affiliated Hospital of Xi'an Jiaotong University between December 2011 and December 2013 were enrolled in this prospective study. Among the 12 patients, 4 were males and 8 were females with the average age of (55±8) years old. Moreover, 12 healthy people were enrolled in the control group. The informed consents of all patients were obtained and the local ethical committee approval had been received. Percentage of natural killer (NK) cell, natural killer T (NKT) cell, CD4+ cell, CD8+ T cell and CD4+/CD8+ ratio in peripheral blood before and 2, 6 weeks after splenectomy were observed. The comparison on different lymphocyte subsets was conducted using Wilcoxon rank-sum test. Results The percentage of CD3-CD56+CD16+ NK cell 6 weeks after splenectomy was 7.7%, which was significantly higher than 6.2% before splenectomy (T=1.992, P<0.05). And the percentage of CD56dim NK cell 2 and 6 weeks after splenectomy was respectively 94.9% and 96.4%, which was significantly higher than 87.9% before splenectomy (T=2.747, 2.201; P<0.05). The percentage of CD56bright NK cell 2 and 6 weeks after splenectomy was respectively 3.8% and 2.4%, which was significantly lower than 9.2% before splenectomy (T=2.747, 2.201; P<0.05). The percentage of CD3+CD56+ NKT cell 2 and 6 weeks after splenectomy was respectively 7.3% and 7.0%, which was significantly higher than 6.5% before splenectomy (T=2.275, 1.572; P<0.05). Percentage of CD4+ T cell 2 weeks after splenectomy was 41.7%, which was significantly lower than 45.7% before splenectomy (T=3.059, P<0.05), and further decreased to 26.7% 6 weeks after splenectomy (T=2.201, P<0.05), while percentage of CD8+ T cell increased from 21.1% before splenectomy to 24.8% 2 weeks after splenectomy (T=2.432, P<0.05), and further increased to 35.3% 6 weeks after splenectomy (T=1.992, P<0.05). The CD4+/CD8+ ratio before splenectomy was 2.0 and decreased to 1.4 and 0.8 respectively 2 and 6 weeks after splenectomy (T=2.981, 1.992; P<0.05). Conclusion The cellular immune function of patients with HCV related cirrhotic portal hypertension after splenectomy improves significantly. Key words: Liver cirrhotic; Hepatitis C, chronic; Splenectomy; NK cell; T lymphocytes