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Age-dependent variation of lymphocyte function in the postoperative child
Insights
Surgery impacts lymphocyte counts and function in children. Younger pediatric patients experience more significant age-related alterations in lymphocyte counts and reactivity following surgery.
Area of Science:
- Immunology
- Pediatric Surgery
- Anesthesiology
Background:
- Lymphocyte profiles and reactivity naturally change with age.
- Surgical procedures can depress lymphocyte counts and blastogenesis.
- The influence of age on these postoperative immune alterations in children is not well understood.
Purpose of the Study:
- To investigate the relationship between age and lymphocyte alterations in pediatric patients after surgery.
- To analyze how age affects changes in lymphocyte counts and reactivity postoperatively.
Main Methods:
- Assessed perioperative lymphocyte counts (absolute, T-cells, B-cells) and reactivity in 35 healthy children undergoing elective herniorrhaphy.
- Blood samples were collected at anesthesia induction and 2 hours postoperatively.
- Analyzed age-related differences using regression analysis.
Main Results:
- Surgery significantly decreased absolute lymphocyte counts, T-cells, and B-cells.
- Operative-induced changes in absolute and B-cell counts correlated significantly with age.
- Lymphocyte reactivity also decreased significantly, with B-cell response alterations correlating with age.
- Lymphocyte alterations were inversely related to age in all significant correlations.
Conclusions:
- Age is a significant factor influencing the degree of lymphocyte count and reactivity alterations following surgery in children.
- Younger children exhibit more pronounced age-related immune system changes after surgical intervention.
- These findings highlight the importance of considering age in the perioperative immune response of pediatric surgical patients.
Abstract:
Circulating lymphocyte profiles and reactivity normally vary with age. Operation results in depression of both lymphocyte counts and blastogenesis but the relationship of age to these alterations has not been previously evaluated in the pediatric surgical patient. This report analyzes the relationship of age to lymphocyte alteration in the postoperative child. Thirty-five healthy children (age range 1 mo to 12 yr), admitted for elective herniorrhaphy, underwent perioperative lymphocyte assay. Anesthesia consisted of halothane and NO2, and operative time averaged 54 minutes. Three milliliters of heparinized whole blood was obtained at induction of anesthesia and at 2 hours postoperatively. Lymphocytes were separated by Histopaque gradient and assayed for absolute count, total T-cells, and total B-cells. Lymphocyte reactivity was determined by 3H-Thymidine incorporation during incubation with the mitogens phytohemagglutinin (PHA), pokeweed (PWM), and/or concanavalin A (Con A) and results expressed as the logarithm of scintillation counts per minute. Differences in preoperative and postoperative values were analyzed for significance by paired T-test. The same differences were evaluated for relationship to age by regression analysis. Operation resulted in significant decreases in all lymphocyte counts (absolute, T- and B-cells), and the operative-induced alteration in both absolute and total B-cell counts were significantly correlated with age (P less than .03, P less than .007, respectively). Similarly, operation resulted in significant depression of lymphocyte reactivity and alteration in B-cell response (PWM) was significantly correlated with age (P less than .008). In all instances of significant correlation, lymphocyte alterations were inversely related to age.(ABSTRACT TRUNCATED AT 250 WORDS)