RESULTS OF PARTIAL SPLENECTOMY AND TRANSP OSITION OF THE SPLEEN INTO THE LATERAL ABDOMINAL-WALL BY PORTAL-HYPERTENSION IN CHILDHOOD

Between 1977 and 1995, 19 children with portal hypertension (nine extr ahepatic, ten intrahepatic) were treated by transpositioning the splee n into the left abdominal wall. Among the patients with intrahepatic p ortal hypertension three died. Two patients underwent secondary diminu ition of the transposed spleen due to relapsed hypersplenism. In one o f our first patients the transposed spleen atrophied after tangential resection. All surviving patients except one preserved hepatic functio n. The serum colloid osmotic pressure was stable. Plasma ammonia level s were normal. Serum immunoglobulins (IgG, IgM, IgA and IgG subclasses ) and complement components (C3c, C4) were analyzed. After transpositi on patients had normal or slightly elevated values of these proteins c ompared with controls.