The effects of major surgery on lymphocyte subsets in infancy and childhood

Top of pageAbstract A study was designed to test the hypothesis that the lymphopenia caused by surgical stress in children may arise through selective depletion of one or more lymphocyte subsets. Blood samples from 18 children were taken pre- and post-operatively and 6, 12, 24 and 48 hours after surgery. Lymphocyte subsets were identified and counted using monoclonal antibodies and indirect immunofluorescence. By 6 hours post-operatively, the mean total lymphocyte count had fallen by 2.04×10/1 (p<0.01) this was largely due to the fall in helper T-cells (1.70×10/1, p<0.01) and both counts remained depressed for at least 48 hours. The helper:suppressor ratio also fell, from 3.19 to 2.16 (p<0.01), but had recovered by 48 hours. The changes were independent of age. Major surgery in infants and children causes a selective reduction in helper T-lymphocytes with a corresponding decrease in the helper:suppressor ratio, suggesting a reduced immune competence in the immediate post-operative period. The duration of this and its relationship to infection are not yet known.