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Ann Thorac Surg 1993;55:625-630
© 1993 The Society of Thoracic Surgeons

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Articles

Cardiopulmonary bypass and cellular immunity: Changes in lymphocyte subsets and natural killer cell activity

^a Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Osaka, Japan
^b Department of Thoracic Surgery, Nagoya University School of Medicine, Nagoya, Japan

Accepted for publication August 25, 1992.

^_* Address reprint requests to Dr Yamamoto, Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka, 565, Japan.

To investigate whether cell-mediated immunity responses are suppressed or activated by the effect of cardiopulmonary bypass (CPB), we studied peripheral blood lymphocyte subsets and antibody-dependent cellmediated cytotoxicity in 52 adult patients who had undergone open heart operations. Lymphocyte function also was studied with regard to mixed lymphocyte reaction, which indicates the amount of DNA synthesis of lymphocytes, and natural killer (NK) cytotoxicity, which represents the killing activity of NK cells on the tumor cells (K-562), in 11 patients. The total T lymphocyte (OKT3+ and OKT11+) number showed no significant change during CPB. Suppressor/cytotoxic T cell (OKT8+) and NK cell (Leu7+ and Leu11+) numbers were found to be remarkably increased. However, helper/inducer T cell (OKT4+) and B cell (Leu12+) numbers were decreased during CPB. Antibody-dependent cell-mediated cytotoxicity was elevated during CPB. All of these changes were almost returned to the preoperative levels by the seventh day after operation. Mixed lymphocyte reaction and NK cytotoxicity were also activated during CPB. The results show that heart operations in which cardiopulmonary bypass is used are associated with activation of cytotoxic cell-mediated immunity.

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