Impaired systemic immunity and frequent infection in patients with Candida antigen after hepatectomy.
OBJECTIVE
Infection after hepatic resection constitutes a major cause of morbidity and mortality. We examined the role of Candida antigen in systemic immunity and the infectious complications after hepatectomy.


METHODS
In 25 hepatectomized patients, the Candida antigen titers were measured by a latex agglutination test (CAND-TEC). In the patients with Candida antigen (n = 10; 40%) and those without (n = 15; 60%), multiple immunological parameters, including the total lymphocyte count, lymphocyte subpopulations, phytohemagglutinin (PHA) response, and natural killer (NK) activity, and the incidence of infectious complications were compared.


RESULTS
In the preoperative and operative parameters, there were no significant differences between the two groups. In the postoperative immune parameters, a significant attenuation in the total lymphocyte number (p < 0.01) and NK activity (p < 0.01) was observed in the patients with Candida antigen, compared with the findings in patients without Candida antigen. A bacterial infection was identified in 5 of 10 patients (50.0%) with Candida antigen, and in 1 of 15 patients (6.7%) without Candida antigen (p < 0.05). In contrast, the Candida culture was negative for all patients.


CONCLUSIONS
Both a profound attenuation of systemic immunity and frequent bacterial infections were observed in the hepatectomized patients with Candida antigen.
Shirabe
K
K
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Takenaka
K
K
Yamatomto
K
K
Kawahara
N
N
Itasaka
H
H
Nishizaki
T
T
Yanaga
K
K
Sugimachi
K
K
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D015703:Antigens, CD / Q000032:analysis; D000946:Antigens, Fungal / Q000032:analysis*; D001424:Bacterial Infections / Q000276:immunology*; D018988:Bacterial Translocation; D002176:Candida albicans / Q000276:immunology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007109:Immunity; D007841:Latex Fixation Tests; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology* / Q000382:microbiology
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D000946:Antigens, Fungal