Autologous spleen replantation
Autologous spleen replantation can overcome the rejection after organ transplantation, and the spleen regeneration ability is good, and the recovery of patients after surgery is better. Treatment of diseases: traumatic spleen rupture spleen rupture Indication 1. Severe spleen tears (spleen parenchyma or spleen, main branches of veins), fierce hemorrhage, no or no repair or partial splenectomy in situ, but rapid removal of the whole spleen, after resection It was found that one of the spleen had a severe rupture, and most of the other spleen was intact and could be used for spleen transplantation. 2, severely spleen, the ligaments are excessively loose, there is the possibility of spleen pedicle torsion, such as the ligament stenosis surgery, and the spleen vascular distortion may affect the spleen blood supply or venous return. 3, severe hemophilia A, lack of anti-hemophilia globulin, the active part of the VIII coagulation factor. 4. Immunodeficiency diseases such as congenital immunodeficiency and gamma globulin deficiency. 5. Lipid-like deposition (high snow disease and Niemann-Pick disease). 6. Patients caused by radiation. 7, advanced malignant tumors as a treatment of inhibition. 8, multiple organ combined transplantation. Contraindications 1. Human immunodeficiency virus (HIV) is positive in the patient's serum. 2. Severe brain, heart, and lung dysfunction patients. 3. The patient has an uncontrollable psychopath. 4. The patient's systemic infection has not been controlled. 5, there are serious mental stagnation patients. 6, other organ failure, such as liver failure with obvious jaundice, ascites and portal hypertension esophageal varices bleeding. Preoperative preparation Precautions: 1. Through the trimming of the arterial end, try to make the diameter of the two arteries at the anastomosis of the artery consistent. 2, if arterial spasm occurs, fine needle puncture can be used to inject procaine to relieve. 3. There are many valves in the iliac vein. When the splenic vein is anastomosed, the venous valve should be avoided to prevent the anastomosis from being blocked by the venous valve. 4, before the completion of the vascular anastomosis, the heparin solution should be carefully washed to prevent the occurrence of air embolism, especially the anastomosis of the artery is particularly important. 5, the spacing of the needle should be appropriate when the anastomosis, in order to avoid leakage of the anastomosis, the inner, middle and outer membranes must be sutured together. 6. After the blood vessels are open, there is obvious blood leakage, which can strengthen the suture, and pay attention to not suturing the side wall. The small blood leakage can be applied with hot saline gauze for a while. 7. When using Satura's forceps to block the common iliac vein, the position of the placed forceps should be appropriate, that is, the blood flow at the anastomosis is completely blocked, and the reflux of the venous blood of the lower limbs is not affected. 8. If necessary, fix the needles of the spleen to prevent the spleen from twisting. Preoperative preparation: Antibiotics are routinely used before surgery.
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