Lymphocyte activation after blood transfusion, major surgery and skin testings

The proportion of lymphocytes passing through the S-phase of the cell cycle was determined in peripheral blood lymphocytes taken seven days after major surgery, blood transfusion or delayed hypersensitivity skin testing with recall antigens. The unstimulated incorporation of 3H-thymilidine in-vitro, during a two hour incubation period was assessed by scintillation counting and autoradiography. Healthy subjects were studied in parallel. Fifteen patients undergoing surgery without blood transfusion showed a significant increase in lymphocyte activation compared with controls [P< 0.025]. In 12 patients blood transfusion alone produced a greater increase [P< 0.01] but the greatest response was seen in 20 patients who received intra-operative blood transfusions [P< 0.001]. Skin Test antigens [10 patients] did not produce a statistically significant increase in activated lymphycytes. The origin, nature and clinical significance of these activated lymphocytes requires further elucidation

Measurement of immune function in surgical patients: their relationship to post-operative infection

A wide spectrum of laboratory tests was applied to a 20 patients, before and after surgery, to assess their susceptibility to infection. Four developed intra-abdominal sepsis and live suffered from minor 5 common antigers were variable and did not relate to the development of infection. Phytohaemagglutin [PHA] induced lymphocyte transformation did not show any marked change and again failed to predict infection in individual patients. The number of polymorphs in the blood rose and the number of lymphocytes fell in the immediate postoperative period. The latter was apparently related to the precipitious rise in serum cortisol found immediately after operation. The levels of immunoglobulins g, A and M and comlement components C1 q, C3, C4 and B showed some significant changes but there was no evidence of a deficit in a single immune mechanism after surgery. two striking findings were a doubling, on the seventh post-operative day, of the lymphocyte response to PHA stimulation in medium supplemented with autologous serum and on the same day, an increased number of lymphocytes DNA without mitogenic stimulation