[The immune response following open-heart surgery].
The immune responses following open-heart surgery especially with simple deep hypothermia were investigated in 16 patients who underwent open-heart surgery with simple deep hypothermia, in 9 patients who underwent open-heart surgery with cardiopulmonary bypass and in 9 patients who underwent thoracic surgery. The following examinations were performed before operation, on the first, third, seventh and fourteenth postoperative day: 1) total number of leukocytes and lymphocytes 2) total number of lymphocyte subpopulations (T cells, B cells, Leu2a positive cells, Leu3a positive cells) 3) serum concentration of immunoglobulins (IgG, IgA, IgM). Leu2a and Leu3a positive cells were enumerated using flow cytometry. The results were as follows: 1. There was significant leukocytosis in all groups on the first postoperative day. In case of cardiopulmonary bypass, this leukocytosis remained longer than those of simple deep hypothermia. 2. Total number of lymphocytes decreased significantly after open-heart surgery both with simple deep hypothermia and cardiopulmonary bypass on the first and third postoperative day. The number of T cells (Leu2a positive cells and Leu3a positive cells) were also decreased. After simple deep hypothermia, however, there was tendency to increase numbers of lymphocytes and T cells from the third postoperative day. 3. The level of immunoglobulins (IgG, IgA, IgM) were not less than normal range in all patients. After simple deep hypothermia, IgM level increased on the seventh and fourteenth postoperative day. The results showed a significant decrease of total lymphocyte count, Leu2a and Leu3a positive cell count following open-heart surgery. However, after simple deep hypothermia the suppression was mild.
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D000328:Adult; D000917:Antibody Formation; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D006801:Humans; D007036:Hypothermia, Induced; D007111:Immunity, Cellular; D008875:Middle Aged