The effect of cardiac surgery on peripheral blood lymphocyte populations.
BACKGROUND
Cardiac surgery using cardiopulmonary bypass (CPB) is associated with some adverse postoperative complications caused by an altered immune response. An alternative approach to cardiac surgery, operating without the use of CPB (i.e. off-pump surgery), seems to display less adverse impacts on the immune response.


METHODS
Peripheral blood lymphocytes in 40 patients undergoing cardiac surgery either with CPB ("on-pump") or without CPB ("off-pump") were followed using flow cytometry. The samples of peripheral blood were taken at five intervals: preoperatively, after termination of the surgery, on the first, on the third and on the seventh postoperative day, respectively.


RESULTS
The most substantial changes appeared on the first postoperative day in both subgroups of patients. While the percentage of both total T cells and CD4+ T cells were decreased, the percentage of HLA-DR+ activated lymphocytes was increased. These changes were more profound in the "on-pump" subgroup compared to the "off-pump" subgroup.


CONCLUSIONS
Our results may suggest that the "off-pump" surgical approach reveals less adverse impact on adaptive immune responses.
Jankovicová
Karolina
K
Department of Clinical Immunology and Allergology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Králové, Czech Republic.
Kudlová
Manuela Trojácková
MT
Kolácková
Martina
M
Kunes
Pavel
P
Mand'ák
Jirí
J
Lonský
Vladimir
V
Vlásková
Dana
D
Andrýs
Ctirad
C
Krejsek
Jan
J
D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male