mutual interrelation between major surgical trauma and the immunological response as measured by spontaneous rosette formation

ABSTRACT

The cell mediated immune response was studied by rosette formation in 24 patients before and after major surgery. Nine patients [37.5%] showed preoperative reduction in the number of T lymphocytes, and these patients continued to be suppressed postoperatively. Out of the other 15 patients, nine cases [60%] developed a de novo postoperative fall in their T lymphocyte population; this can be attributed to operative trauma. Among the overall 18 immunosuppressed patients in the postoperative period, 12 developed infection, 5 had other complication, while one died. This last patient had both preoperative and postoperative reduction of T lymphocytes. Infection was encountered in all the 9 patients with preoperative immunodepression, but only in 3 out of the 9 patient who developed postoperative suppression; a finding that may point to greater role of preoperative reduction of T lymphocytes than surgical trauma in the pathogenesis of postoperative morbidity