Allotransplantation of Whole Spleen in Patients With Hepatic Malignant Tumors or Hemophilia A

We read with interest the report by Liu et al 1 in the January issue of theArchives. They performed heterotopic allotransplantation of whole spleen in six patients with hemophilia A or advanced hepatocellular carcinoma. The results showed that the allografted spleen produced coagulating factor VIII and suggested that splenic allotransplantation had a positive effect against unresectable hepatocellular carcinoma. We congratulate the successful cases in the former group based on many scientific works. 2 However, the effect of the transplanted spleen on patients with malignant disease is still controversial. From our clinical data on total gastrectomy with splenectomy in patients with advanced gastric cancer and metastatic lymph nodes of the splenic hilum, the positive effect of splenectomy is considered for curative procedures, but its effect on patient prognosis is controversial because no randomized study has been done and there is a lack of knowledge about its mechanism. We are looking