The effect of cardiac surgery on peripheral blood lymphocyte populations
Karolina Jankovicová1, Manuela Trojácková Kudlová, Martina Kolácková
1Department of Clinical Immunology and Allergology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Králové, Czech Republic.
Insights
Off-pump cardiac surgery, avoiding cardiopulmonary bypass (CPB), appears to cause fewer immune system changes than on-pump surgery. This suggests off-pump procedures may offer a gentler approach for patients undergoing heart operations.
Area of Science:
- Immunology
- Cardiovascular Surgery
Background:
- Cardiopulmonary bypass (CPB) in cardiac surgery can trigger adverse immune responses and complications.
- Off-pump cardiac surgery, performed without CPB, is being investigated as a potentially less immunotoxic alternative.
Purpose of the Study:
- To compare the impact of on-pump versus off-pump cardiac surgery on peripheral blood immune cell populations.
- To evaluate adaptive immune responses following different cardiac surgical techniques.
Main Methods:
- Flow cytometry was used to analyze peripheral blood lymphocytes from 40 patients.
- Samples were collected preoperatively and at five postoperative time points (immediate, day 1, day 3, day 7).
- Patients were divided into on-pump (with CPB) and off-pump (without CPB) subgroups.
Main Results:
- Significant immune changes were observed on postoperative day 1 in both groups.
- On-pump surgery showed a more profound decrease in total T cells and CD4+ T cells.
- A greater increase in HLA-DR+ activated lymphocytes was noted in the on-pump group compared to the off-pump group.
Conclusions:
- Off-pump cardiac surgery demonstrates a less adverse effect on adaptive immune responses compared to on-pump surgery.
- The findings suggest that avoiding CPB may mitigate immune system disturbances post-cardiac surgery.
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.
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