Skip to main content
Clinical and Experimental Immunology logoLink to Clinical and Experimental Immunology
. 1984 Apr;56(1):49–57.

The significance of changes in blood lymphocyte populations following surgical operations.

J Hamid, J Bancewicz, R Brown, C Ward, M H Irving, W L Ford
PMCID: PMC1535958  PMID: 6232025

Abstract

After surgery blood lymphocyte levels fell to one-third of the pre-operative value. Since this depression was transient, and followed the peak of serum cortisol closely, it was probably due to a redistribution of lymphocytes from the blood to the tissues. The proportion of activated lymphocytes, as measured by the incorporation of 3H-thymidine in vitro without added mitogen, was substantially increased about 5-8 days after operation. The greatest number of S-phase lymphocytes was found after operation combined with blood transfusion but surgery alone and blood transfusion alone each produced significant increases. The proportions of B lymphocytes, T helper cells and T suppressor cells remained nearly constant despite the fluctuations in total lymphocyte counts. The response of lymphocytes in vitro to phytohaemagglutin (PHA) was doubled on average 7 days after surgery provided the test was performed in the patient's own serum. In pooled serum there was no consistent change in the response to PHA. It is argued that none of the observed changes necessarily signify that a phase of immunosuppression follows surgical operations.

Full text

PDF
49

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bancewicz J., Gray A. C., Lindop G. The immunosuppressive effect of surgery--a possible mechanism. Br J Surg. 1973 Apr;60(4):314–315. [PubMed] [Google Scholar]
  2. Barton R. N., Passingham B. J. Effect of binding to plasma proteins on the interpretation of plasma cortisol concentrations after accidental injury. Clin Sci (Lond) 1981 Oct;61(4):399–405. doi: 10.1042/cs0610399. [DOI] [PubMed] [Google Scholar]
  3. Bergman S., Borgström S., Tärnvik A. Lymphocyte response to phytohaemagglutinin following cholecystectomy. Acta Pathol Microbiol Scand. 1969;75(3):363–366. [PubMed] [Google Scholar]
  4. Brown R., Bancewicz J., Hamid J., Patel N. J., Ward C. A., Farrand R. J., Pumphrey R. S., Irving M. Failure of delayed hypersensitivity skin testing to predict postoperative sepsis and mortality. Br Med J (Clin Res Ed) 1982 Mar 20;284(6319):851–853. doi: 10.1136/bmj.284.6319.851. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Constantian M. B., Menzoian J. O., Nimberg R. B., Schmid K., Mannick J. A. Association of a circulating immunosuppressive polypeptide with operative and accidental trauma. Ann Surg. 1977 Jan;185(1):73–79. doi: 10.1097/00000658-197701000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cox J. H., Ford W. L. The migration of lymphocytes across specialized vascular endothelium. IV. Prednisolone acts at several points on the recirculation pathways of lymphocytes. Cell Immunol. 1982 Jan 15;66(2):407–422. doi: 10.1016/0008-8749(82)90190-3. [DOI] [PubMed] [Google Scholar]
  7. Crowther D., Fairley G. H., Sewell R. L. Lymphoid cellular responses in the blood after immunization in man. J Exp Med. 1969 May 1;129(5):849–869. doi: 10.1084/jem.129.5.849. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Espanol T., Todd G. B., Soothill J. F. The effect of anaesthesia on the lymphocyte response to phytohaemagglutinin. Clin Exp Immunol. 1974 Sep;18(1):73–79. [PMC free article] [PubMed] [Google Scholar]
  9. Farmer R. W., Pierce C. E. Plasma cortisol determination: radioimmunoassay and competitive protein binding compared. Clin Chem. 1974 Apr;20(4):411–414. [PubMed] [Google Scholar]
  10. Hakim A. A. An immunosuppressive factor from serum of thermally traumatized patients. J Trauma. 1977 Dec;17(12):908–919. doi: 10.1097/00005373-197712000-00004. [DOI] [PubMed] [Google Scholar]
  11. Keiser H., Kushner I., Kaplan M. H. "Nonspecific" stimulation of lymphocyte transformation by cellular fractions and acid extracts of group A streptococci. J Immunol. 1971 Jun;106(6):1593–1601. [PubMed] [Google Scholar]
  12. Lobo P. I., Westervelt F. B., Horwitz D. A. Identification of two populations of immunoglobulin-bearing lymphocytes in man. J Immunol. 1975 Jan;114(1 Pt 1):116–119. [PubMed] [Google Scholar]
  13. MacLean L. D. Host resistance in surgical patients. J Trauma. 1979 May;19(5):297–304. doi: 10.1097/00005373-197905000-00001. [DOI] [PubMed] [Google Scholar]
  14. Moorhead J. W., Claman H. N. Thymus-derived lymphocytes and hydrocortisone: identification of subsets of theta-bearing cells and redistribution to bone marrow. Cell Immunol. 1972 Sep;5(1):74–86. doi: 10.1016/0008-8749(72)90085-8. [DOI] [PubMed] [Google Scholar]
  15. Opelz G., Terasaki P. I. Improvement of kidney-graft survival with increased numbers of blood transfusions. N Engl J Med. 1978 Oct 12;299(15):799–803. doi: 10.1056/NEJM197810122991503. [DOI] [PubMed] [Google Scholar]
  16. Park S. K., Brody J. I., Wallace H. A., Blakemore W. S. Immunosuppressive effect of surgery. Lancet. 1971 Jan 9;1(7689):53–55. doi: 10.1016/s0140-6736(71)90777-x. [DOI] [PubMed] [Google Scholar]
  17. Repo H., Kostiala A. A., Kosunen T. U. Cellular hypersensitivity to tuberculin in BCG-revaccinated persons studied by skin reactivity, leucocyte migration inhibition and lymphocyte proliferation. Clin Exp Immunol. 1980 Feb;39(2):442–448. [PMC free article] [PubMed] [Google Scholar]
  18. Riddle P. R. Disturbed immune reactions following surgery. Br J Surg. 1967 Oct;54(10):882–886. doi: 10.1002/bjs.1800541022. [DOI] [PubMed] [Google Scholar]
  19. Schechter G. P., Soehnlen F., McFarland W. Lymphocyte response to blood transfusion in man. N Engl J Med. 1972 Dec 7;287(23):1169–1173. doi: 10.1056/NEJM197212072872303. [DOI] [PubMed] [Google Scholar]
  20. Slade M. S., Simmons R. L., Yunis E., Greenberg L. J. Immunodepression after major surgery in normal patients. Surgery. 1975 Sep;78(3):363–372. [PubMed] [Google Scholar]
  21. Spry C. J. Inhibition of lymphocyte recirculation by stress and corticotropin. Cell Immunol. 1972 May;4(1):86–92. doi: 10.1016/0008-8749(72)90007-x. [DOI] [PubMed] [Google Scholar]
  22. Van Hoff J. P., Kalff M. W., Van Poelgeest A. E., Perslin G. G., Van Rood J. J. Blood transfusions and kidney transplantation. Transplantation. 1976 Sep;22(3):306–308. doi: 10.1097/00007890-197609000-00014. [DOI] [PubMed] [Google Scholar]
  23. Winchester R. J., Fu S. M., Hoffman T., Kunkel H. G. IgG on lymphocyte surfaces; technical problems and the significance of a third cell population. J Immunol. 1975 Apr;114(4):1210–1212. [PubMed] [Google Scholar]

Articles from Clinical and Experimental Immunology are provided here courtesy of British Society for Immunology

RESOURCES