Role of splenectomy in renal transplantation

One hundred sixteen renal transplants in 99 patients were reviewed. Patients were divided into four groups: 53 live donor recipients with pretransplant splenectomy, 13 nonsplenectomized live donor recipients, 20 cadaver recipients with splenectomy, and 30 nonsplenectomized cadaver recipients. Nonsplenectomized live donor recipients had fewer rejection episodes per month of graft function (p < 0.005). Serum creatinine in functioning grafts showed no differences between splenectomized and nonsplenectomized patients. In 73 splenectomized patients there were 14 related septic and/or thromboembolic complications, 6 fatal. Mean daily azathioprine dosage was greater in splenectomized patients (p < 0.005). There were no hyperacute rejections of second transplants in splenectomized patients, while 2 occurred in 8 nonsplenectomized patients. Splenectomy prior to renal transplantation did not decrease the number of rejection episodes per month of graft function and was associated with a higher rate of septic and thromboembolic complications.