During the past 12 months, five clinical whole-organ splenic homotransplantations have been carried out with the objective of providing active immunologic tissue for the recipient patients. In one case with hypogammaglobulinemia, it was hoped that the transplanted tissue would alleviate a state of immunologic deficiency. In the other four, all of whom had terminal malignancies, the purpose was to superimpose a state of altered immunologic reactivity upon the host in the hope of thereby suppressing the inexorable growth of the neoplasms.
As will be described, these procedures can now be judged in each instance to have been without benefit. Nevertheless, full documentation of the cases seems justified not only because of the many implications of transplantation of immunologically competent tissue, but also because of the potentially important observations made during the care of these patients.
In addition, a full account will be presented of the supporting canine studies of splenic homotransplantation, inasmuch as many of the principles of clinical therapy and investigation derived from prior observations in the dog. The fact that it is possible to obtain viable splenic homografts in the dog for as long as two-thirds of a year without the production of runt disease or other harmful effects may have application in future research on bone marrow, other lymphoid, or hepatic homografts.