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[Studies of pathogenicity of GVHD induced by blood transfusion after open heart surgery]
K Hisatomi1, T Isomura, S Shimada
1Second Department of Surgery, Kurume University School of Medicine, Japan.
We compared the case like acute GVHD (graft versus host disease) induced by blood transfusion with the cases after open heart surgery which received blood transfusion by the measurement of cell-mediated immunity. Furthermore, we investigated the etiology of GVHD in comparison with cases according to age. Seventy-three cases (under 60 years old: 55 cases, over 60 years old: 18 cases) underwent open heart surgery and the mean blood transfusion volume was 2368cc and the mean age was 52.8 years old. After open heart surgery the rate of peripheral OKT3+ and OKT4+ cells, lymphocyte transformation and IL-2 (interleukin 2 product) were significantly decreased at postoperative day (POD) 1 and recovered to preoperative value until POD 14. However, in the cases like GVHD the rate of OKT4+ cell was decreased in contrast with the change of OKT8+ cell, and lymphocyte transformation and IL-2 production did not recover to normal range postoperatively. In conclusion, in the cases like GVHD the postoperative charge of cell-immunity is similar to the acute GVHD induced after bone marrow transplantation and we must take care about the blood transfusion to the older patients after open heart surgery because there is a possibility that cell-mediated immunity may be more depressed in the elder patient pre and postoperatively.
We compared the case like acute GVHD (graft versus host disease) induced by blood transfusion with the cases after open heart surgery which received blood transfusion by the measurement of cell-mediated immunity. Furthermore, we investigated the etiology of GVHD in comparison with cases according to age. Seventy-three cases (under 60 years old: 55 cases, over 60 years old: 18 cases) underwent open heart surgery and the mean blood transfusion volume was 2368cc and the mean age was 52.8 years old. After open heart surgery the rate of peripheral OKT3+ and OKT4+ cells, lymphocyte transformation and IL-2 (interleukin 2 product) were significantly decreased at postoperative day (POD) 1 and recovered to preoperative value until POD 14. However, in the cases like GVHD the rate of OKT4+ cell was decreased in contrast with the change of OKT8+ cell, and lymphocyte transformation and IL-2 production did not recover to normal range postoperatively. In conclusion, in the cases like GVHD the postoperative charge of cell-immunity is similar to the acute GVHD induced after bone marrow transplantation and we must take care about the blood transfusion to the older patients after open heart surgery because there is a possibility that cell-mediated immunity may be more depressed in the elder patient pre and postoperatively.