The Effect of Cardiac Surgery on Peripheral Blood Lymphocyte Populations

Abstract

Summary: 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. Patients and 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. Conclusion: Our results may suggest that the "off-pump" surgical approach reveals less adverse impact on adaptive immune responses.

Evaluation of Reasons of the Damages after Simav and Van (2011) Earthquakes

“…In our study we detected acute increase in white blood count but we did not detect specific lymphocytic increase (p>0.05) (Table 2). Contrast to our results there are papers advocating specific increase of lymphocyte is associated with mortality (17,18) . In our study we detected statistically significant association with prolonged ventilation and mortality.…”

Comparison of neutrophil:lymphocyte ratios following coronary artery bypass surgery with or without cardiopulmonary bypass

“… 2 Production of reactive oxygen species, decreased barrier function, induction of hypoperfusion, and tissue destruction are examples of adverse outcomes resulting from severe activation of the native immunity. 3 Cardiopulmonary bypass circuit devices play a key role at that point, with contact activation of both cellular and humoral components of the blood accepted as major liability issues. T and B cells of the adaptive immune system are affected mostly in the early postoperative period with some delay in the course of surgery.…”