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Immune Function After Splenic Artery Embolization for Blunt Trauma: Long-Term Assessment of CD27+ IgM B-Cell Levels
Affiliation:1. Department of Radiology, Alfred Health, Melbourne, Victoria, Australia;2. Department of Neuroscience, Monash University, Melbourne, Victoria, Australia;3. Department of Respiratory Medicine-Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, Victoria, Australia;4. Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia;5. Department of Surgery, Monash University, Melbourne, Victoria, Australia;6. National Trauma Research Institute, Melbourne, Victoria, Australia
Abstract:Splenic artery embolization (SAE) plays a critical role in the treatment of high-grade splenic injury not requiring emergent laparotomy. SAE preserves splenic tissue, and growing evidence demonstrates preserved short-term splenic immune function after SAE. However, long-term function is less studied. Patients who underwent SAE for blunt abdominal trauma over a 10-year period were contacted for long-term follow-up. Sixteen participants (sex: women, 10, and men, 6; age: median, 34 years, and range, 18–67 years) were followed up at a median of 7.7 years (range, 4.7–12.8 years) after embolization. Splenic lacerations were of American Association for the Surgery of Trauma grades III to V, and 14 procedures involved proximal embolization. All individuals had measurable levels of IgM memory B cells (median, 14.30 as %B cells), splenic tissue present on ultrasound (median, 122 mL), and no history of severe infection since SAE. In conclusion, this study quantitatively demonstrated that long-term immune function remains after SAE for blunt abdominal trauma based on the IgM memory B cell levels.
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