LONG-TERM VENOUS ACCESS USING ENDOGENOUS SPLENIC TISSUE - THE SPLEEN-O-PORT

The authors sought to determine whether endogenous splenic tissue plac ed in a subcutaneous pouch (''spleen-o-port'') could function as a via ble alternative to central venous catheters/ports for long-term venous access. A small transverse incision was made in the left upper quadra nt of each puppy in = 6) under general anesthesia. Using a stapler, th e authors divided the splenic parenchyma. The superior portion was ret urned to its native location, and a subcutaneous pocket was created to house the inferior pole with its attached vascular supply. The fascia l and muscular layers were closed with care to avoid compressing the b lood supply to the spleen-o-port. Postoperatively the dogs resumed nor mal activity. There have been no deaths, infectious complications, spl enic ruptures, or thromboses over a B-month period. Under fluoroscopy, the dogs were imaged from postoperative day (POD) 10 to 177. Contrast agent entering the splenic parenchyma was promptly visualized in the splenic vein and then filled the portal vein. Electrolyte measurements from spleen-o-port blood samples were identical to those from periphe ral venous samples. After gentamicin (mixed in a crystalloid solution) was infused through the spleen-o-port, the peak serum level correspon ded to the therapeutic levels observed after standard intravenous admi nistration. The spleen-o-port permits rapid infusion of drugs and crys talloid, and allows repetitive blood sampling while eliminating the fo reign body that can promote septicemia in the immunocompromised patien t. Copyright (C) 1995 by W.B. Saunders Company