Spleen removal w/ liver and bowel transplant?

[nursepearl]

I have looked this question up online but havent come up with an answer.

So, why, if a spleen is functioning normally, would it be removed with a liver and bowel transplant?

[TazziRN, RN]

Along the same lines: why, if the recipient's adrenal gland is functioning, is the gland removed along with the kidney from a living donor?

[gwenith, BSN, RN]

Sometimes rejection is less if there is a combination transplant. I know that it is easier to do a heart/lung transplant than just a lung transplant but I am unsure of all of the reasons why.

[augigi, CNS]

It's not easier to do a block heart/lung than a single lung. Usually the reason for doing combined heart/lung is when the native pulmonary vasculature is high pressure (pulmonary hypertension), and will damage the new heart by exerting high pressure and causing pump failure in the new heart.

The only reason I can find for removing a spleen at liver transplant is that they are frequently damaged/nicked at transplant, and it's not really necessary, so you can avoid later complications. Not really sure though, sorry.

[EricJRN, MSN, RN]

The spleen is involved in immune defense, and there's some evidence in the literature that organ rejection will be lessened by removing the spleen.

[Hoozdo, ADN]

The spleen is involved in immune defense, and there's some evidence in the literature that organ rejection will be lessened by removing the spleen.

That is interesting.

My thoughts are that most people needing liver transplants also have splenomegaly. Perhaps, there is not space for the spleen when doing a bowel and liver transplant to close the abdomen with an enlarged spleen.