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RESTOre trial - new research supported by LAPR&D

6/5/2018

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The RESTORE trial - also referred to as Autogenic Splenic Implantation - is being undertaken by Alma Moekotte – Research  Fellow at the University Hospital, Southampton under the supervision of Prof Mohammed Abu Hilal.

This new research is being supported with from LAPR&D, research fees from the Spire Hospital Southampton and a senior investigator grant from the National Institute for Health Research (NIHR) which was awarded to Professor Primrose, who is a key research member on this project.

The spleen is located at the tail end of the pancreas (see photo).  If someone has a tumour in the body or tail of the pancreas, the pancreas, or part of it, will be resected (cut out).  Often the spleen will be removed as well because the blood supply to the spleen is situated very close to the pancreas and sometimes goes through the pancreas.  In that case it is not always possible to divert the blood vessels that go to the spleen, from the pancreas so they have to be removed with the pancreas.  As a result the spleen will not receive any blood and will eventually die.  For this reason the spleen must be resected as well.  Sometimes it is possible to divert the vessels that support the blood supply and keep the spleen alive.

The spleen plays an important role in clearing bacterial infections.  Without a lifelong course of antibiotics & regular vaccinations there is a risk of severe infectious complications.  As a result of these consequences, several investigators have tried to re-implant pieces of the resected spleen.  The procedure is relatively simple:  The resected spleen is cut into pieces, about one third of these pieces are placed back into the abdomen, the body will create new small blood vessels to supply these pieces with blood.  As a result the new pieces of spleen will regenerate and become new splenic tissue.
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However, the question is - will the splenic function be restored?  Or are these new pieces of spleen not functional at all?  This research project will try to answer this question.

The research will follow patients who have undergone spleen auto-transplantation.  After 6 months  participants will be vaccinated with the Salmonella vaccine.  Before and 1 month after the vaccination, we will measure the amount of Anti-bodies against salmonella in the blood.  This gives us an idea whether the new pieces of spleen are able to make enough antibodies to clear an infection. The Salmonella vaccine is chosen because it mimics the specific encapsulated bacteria that are dangerous in patients without a spleen.  Of course the vaccine is harmless to the patient.  We hope this research will lead to a new way of restoring the splenic function and therefore patients no longer require daily antibiotics and regular vaccinations.

The project will start shortly.  The protocol is written and we are waiting for ethical committee clearance.
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Further updates will be provided on our website.
 
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1 Comment
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