
Italian doctors successfully transplant a kidney in the place of the spleen - vanni
http://www.thelocal.it/20161214/italian-doctors-transplant-kidney-for-spleen-in-world-first
======
carbocation
I just want to point our that the title, "Italian doctors transplant kidney
for spleen," remains misleading, to my eyes. This isn't as interesting as it
sounds.

The patient had renal failure and needed a transplant. Due to vascular
anatomy, it sounds like the lower abdomen was not an appropriate place for a
new transplanted kidney.

The innovative technique was to sacrifice the spleen to create a space for the
kidney, then to use the intact splenic vasculature to hook up to the
transplanted kidney.

The spleen is a lymphoid organ that people can live without. Many people with
sickle cell disease are "functionally" asplenic. It can be removed after
injury. Etc. It's a highly vascular organ and has a robust supply via the
splenic artery.

In no way does the kidney perform the function of the spleen.

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sctb
Thanks, we've updated the title again to help clarify.

~~~
matco11
The current title is still misleading as it overcorrected in the other
direction: now it sounds like the doctors made a mistake.

If the word "innovative" sounds like inappropriate - which I am not sure why
that would be the case, given this was a "first-ever" technique, at least
"successfully" should be added in the title to avoid it sounding like there
was a mishap.

~~~
sctb
Yes, thank you. We've added "successfully".

~~~
niels_olson
I would change it to "Italian doctors graft kidney to splenic vasculature,
sacrificing immune function for intra-abdominal real estate".

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vanni
Other sources:

[http://www.thelocal.it/20161214/italian-doctors-
transplant-k...](http://www.thelocal.it/20161214/italian-doctors-transplant-
kidney-for-spleen-in-world-first)

[http://torino.repubblica.it/cronaca/2016/12/14/news/torino_t...](http://torino.repubblica.it/cronaca/2016/12/14/news/torino_trapiantato_un_rene_al_posto_della_milza_e_il_primo_intervento_al_mondo-154081884/)
[ITALIAN]

~~~
gus_massa
The Italian link has more info. Thanks. Autotransaltion:
[https://translate.google.com/translate?sl=auto&tl=en&u=http%...](https://translate.google.com/translate?sl=auto&tl=en&u=http%3A%2F%2Ftorino.repubblica.it%2Fcronaca%2F2016%2F12%2F14%2Fnews%2Ftorino_trapiantato_un_rene_al_posto_della_milza_e_il_primo_intervento_al_mondo-154081884%2F%3Frefresh_ce)

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emilecantin
As a French-speaking person, I was a bit confused by the word "Spleen", as it
means something akin to "Melancholy" in French (it was mostly used by
Renaissance poets like Beaudelaire), but I always assumed it was an anglicism
or something so I really wasn't expecting it to be a body part.

What's kind of funny is that the French word for this organ, "rate", is used
in the idiom "Se dilater la rate", which means laughing a lot.

So the same organ's name is related to both sadness and laughter, depending on
the language.

I now realize that I still don't know what a spleen is or what it does in the
body; time to fire up Wikipedia!

~~~
jessaustin
I didn't know until I looked at a dictionary just now that "spleen" can mean
"melancholy" in English too... The more common emotional meaning would be
something more like "spite" or "anger"; hence the adjective "splenetic". One
gets the impression that each different emotion associated with this word
corresponds to a different idiosyncratic medieval theory about the emotions
originating in the viscera.

~~~
Thnboi666
[https://en.wikipedia.org/wiki/Galen#Contributions_to_medicin...](https://en.wikipedia.org/wiki/Galen#Contributions_to_medicine")

Galen and Hippocrates vital humors theory

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noobermin
And I was expecting a malpractice mix-up. Can any biologist folk explain how
this is possible?

~~~
gus_massa
Weird. IIUC, it looks like they removed (partially?) the spleen to get some
room to put an additional kidney, not to replace the functionality of the
spleen. Do someone has a link with more info? Can any biologist/medic folk
explain more???

~~~
mikecsh
I don't think this can be the whole story. Normally when a kidney is
transplanted into a patient, the defective kidneys are not removed (adds
unnecessary risk). There is plenty of space to add a kidney without removing
the spleen so there must be more to this!

~~~
jessriedel
Yep, and in particular it's not difficult to get sufficient access to
circulatory system.

[http://my.clevelandclinic.org/health/treatments_and_procedur...](http://my.clevelandclinic.org/health/treatments_and_procedures/kidney-
transplant/hic-kidney-transplant-procedure)

We definitely need more info.

EDIT: Actually, looks like it was in fact an issue of space and blood vessels.
From the Google-translation of the Italian article linked elsewhere in the
comments:

> The particular malformation of the baby made it impossible for the kidney
> system donated by the classic conventional technique. The only option then
> was to use another way of connecting to the bloodstream....In order to
> create the necessary space for the new kidney, a revolutionary surgical
> technique which involved the removal of the spleen and the installation of
> the kidney on splenic vessels of the spleen itself along their course behind
> the pancreas was applied. The ureter of the transplanted kidney was then
> implanted directly on the bladder.

[https://translate.google.com/translate?sl=auto&tl=en&u=http%...](https://translate.google.com/translate?sl=auto&tl=en&u=http%3A%2F%2Ftorino.repubblica.it%2Fcronaca%2F2016%2F12%2F14%2Fnews%2Ftorino_trapiantato_un_rene_al_posto_della_milza_e_il_primo_intervento_al_mondo-154081884%2F%3Frefresh_ce)

~~~
mikecsh
Oh how interesting! Thanks for the link!

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randogp
Intentional.

Both kidney and spleen filter blood, although spleen is not essential and can
be removed (splenectomy). Sacrificing the spleen, the surgeon used the spleen
vessels to connect the kidney to the blood circulation. Reading the Italian
news, the vessels of the other kidneys were in bad shape.

~~~
Raphmedia
Does that mean that we could implant a third kidney to people in the future?

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kingkawn
Since the transplant recipient requires immunosuppression anyway it's probably
a good trade off.

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mentioned_edu
This is incredible.

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georgespencer
To be clear: this was intentional.

~~~
erelde
Should there be a renaming here?

It's not intentional clickbait, but my brain did catch that title very quickly
and proceded as fast as it can to make assumptions.

Both titles here[1] are better in my opinion.

[1]:
[https://news.ycombinator.com/item?id=13176066](https://news.ycombinator.com/item?id=13176066)

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duiker101
Being in Italy, just by reading the title there was 50/50 chance that it
wasn't.

~~~
alemhnan
quite racist

~~~
bkmartin
That's not racist. Italy is not a race. It is an indictment of the medical
competency in Italy based on his perception of their system. I wish people
would stop throwing that term around so loosely. If you don't like what he
said, then actually form a coherent rebuttal. Not that his comment was much
better than your own... just making a point here.

~~~
tigroferoce
As an Italian whose wife is working in the public health care system my views
might be a little biased.

Not that Italian system does not have its problems, but we have quite high
life expectancy [1] and our system was ranked second in 2000 by the WHO [2]
and apparently is still quite efficient [3].

And, by the way, it cures just anybody the same, from super rich people to
illegal aliens.

[1]
[https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...](https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy)

[2]
[https://en.wikipedia.org/wiki/World_Health_Organization_rank...](https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000)

[3] [https://www.bloomberg.com/news/articles/2016-09-29/u-s-
healt...](https://www.bloomberg.com/news/articles/2016-09-29/u-s-health-care-
system-ranks-as-one-of-the-least-efficient)

~~~
bkmartin
I was not making any claims of the Italian medical system. I have no idea how
they stack up. I was taking objection to the parent post claiming that the
grandparent post was making a racist statement. If you guys are doing great in
Italy, then awesome! :) Maybe you guys could share some notes with the United
States, particularly when it comes to cost... we need serious help.

~~~
tigroferoce
I totally agree with you. I'm not the best person to ask for advices, but this
guy [1] knows tons about how to run hospitals on budget. The only problem is
that he is perceived as very leftish in Europe, so I guess that in the U.S.
his opinions will never ever be acceptable.

[1]
[https://en.wikipedia.org/wiki/Gino_Strada](https://en.wikipedia.org/wiki/Gino_Strada)

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intellix
your leg bone's connected to your........ hip bone

