Related Experiment Video
Updated: Jun 16, 2026
An Immunological Model for Heterotopic Heart and Cardiac Muscle Cell Transplantation in Rats
Published on: May 8, 2020
The cellular immunological responses of patients undergoing coronary artery bypass grafting compared with those of
Bernard Rudensky1, Amos M Yinnon, Olga Shutin
1Microbiology-Immunology Laboratory, Shaare Zedek Medical Center, Hebrew University - Hadassah Medical School, Jerusalem, Israel. dassyr@zahav.net.il
Insights
Cardiac surgery, including coronary artery bypass grafting (CABG) and valve replacement, causes immune suppression and inflammation. Both procedures similarly impact the immune system, and measured parameters did not predict wound infections.
Area of Science:
- Immunology
- Cardiovascular Surgery
Background:
- Major surgical interventions like cardiac surgery significantly impact the immune system.
- Coronary artery bypass grafting (CABG) and isolated valve surgery are common cardiac procedures with potential immunomodulatory effects.
Purpose of the Study:
- To prospectively compare the immune system effects of coronary artery bypass grafting (CABG) versus isolated valve surgery.
- To assess changes in cellular immunity parameters post-cardiac surgery.
Main Methods:
- Prospective study of 59 patients undergoing elective CABG or valve replacement.
- Blood samples collected preoperatively and on postoperative days 1 and 3.
- Analysis of total and differential cell counts, and cellular immunity parameters via flow cytometry.
Main Results:
- Postoperative increases in white blood cells (WBC) and monocytes, with decreases in lymphocyte populations (CD4, CD8).
- Transient increase in activated T cells on day 1.
- Monocyte activation markers (CD11b, CD64) increased despite decreased human leucocyte antigen-DR (HLA-DR) expression.
- No significant differences in immune parameters between CABG and valve surgery groups.
- No correlation found between measured immune parameters and early wound infections.
Conclusions:
- Cardiac surgery induces a dual state of pro-inflammation and immune suppression.
- Both CABG and valve surgery exert similar effects on the immune system.
- None of the assessed immune parameters predicted the development of postoperative wound infections.
Objective:
Major surgical intervention such as cardiac surgery has been shown to have profound effects on the immune system. We conducted a prospective study comparing the effects of coronary artery bypass grafting (CABG) versus isolated valve surgery.
Methods:
Blood samples were drawn from 59 patients undergoing either elective CABG or elective isolated valve replacement surgery. Samples were obtained preoperatively and on the first and third postoperative days. Total cell counts and differential counts were recorded. Several cellular immunity parameters were determined by flow cytometry.
Results:
On all postoperative days, significant increases in white blood cell (WBC) and monocyte counts were observed. Significant decreases in all lymphocyte populations were also observed with similar decreases in both helper (CD4) and suppressor (CD8) T cells. An increase in activated T cells was noted on day 1, returning to normal on the third postoperative day. Despite the significant decrease in human leucocyte antigen-DR (HLA-DR) antigen expression on monocytes on both the first and third postoperative days, a significant increase in monocyte activation as represented by increased CD11b and CD64 expression was detected. No significant difference was found for any of the measured parameters between the CABG group and the valve replacement group. Eight patients developed early wound infections, with no correlation with any of the measured parameters, including magnitude and duration of decrease in HLA-DR antigen expression on monocytes.
Conclusions:
Cardiac surgery induces both a state of pro-inflammation and of immune suppression. The two major types of cardiac surgery induce similar effects to the immune system. None of the measured parameters was predictive for development of postoperative wound infection.
