Long-term results and indices of immune reactivity in 30 patients who had splenectomy performed in childhood for trauma of the spleen were studied. The organ-preserving approach for this pathology is substantiated. Autotransplantation of the spleen pulp into the pocket formed from the greater omentum was performed in 5 children during splenectomy for trauma of the organ. An original device was used for better preparing the autotransplant. The postoperative period was without complications. The laboratory, sonographic and scintigraphic examinations have shown high functional activity of the transplanted spleen tissue.