Immune Phenotype and Postoperative Complications After Elective Surgery

Area of Science:

• Immunology
• Surgical Complications
• Gerontology

Background:

• Elective surgery represents a controlled injury with variable patient responses.
• Individual immune cell maturation, influenced by lifelong antigen exposure, contributes to this variability.
• Predicting surgical outcomes is challenging due to individual differences in immune compensation.

Purpose of the Study:

• To characterize and quantify immunological alterations before and after elective surgery.
• To investigate the relationship between immune cell phenotypes and postoperative complications.

Main Methods:

• Prospective enrollment of 248 patients undergoing elective surgery.
• Collection of peripheral blood samples preoperatively and post-anesthesia.
• Tracking of 30-day postoperative complications, including infection, readmission, and system dysfunction.

Main Results:

• While overall 30-day survival was 100%, 20.5% of patients experienced postoperative complications.
• Significant heterogeneity in immune senescence and T-cell terminal differentiation was observed.
• Preoperative phenotypes indicating increased T-cell maturation and senescence correlated with postoperative complications.

Conclusions:

• The baseline immune repertoire may serve as an immune signature of resilience to surgical stress.
• This immune signature can potentially predict an individual's risk for surgical complications.
• Identifying these preoperative immune markers could enable personalized risk assessment for elective surgery.