Effect of Anaesthesia and Open‐Heart Surgery on Lymphocyte Responses to Phytohaemagglutinin and Concanavalin A

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Abstract
Cell‐mediated immunity as a part of the immune host defence mechanisms was studied in 32 patients undergoing open‐heart surgery with cardiopulmonary bypass. The thiopentone + N2O + O2 + droperidol + fentanyl + pancuronium anaesthesia did not suppress the phytohaemagglutinin (PHA) and concanavalin A (Con A) responses of lymphocytes in whole blood culture during the first 1.5–2 h of anaesthesia before the beginning of surgery. In contrast, a clear decrease occurred in the PHA and Con A responses after the start of surgery, with a further decrease during extracorporeal circulation. After anaesthesia and operation in the patients subjected to coronary artery and valve replacement surgery, the PHA and Con A responses were only 1–5% of the preoperative day values, while the decrease was smaller in the patients who underwent closure of an atrial septal defect (ASD). The lymphocytic responses in the coronary artery surgery group returned to the preoperative day values in 2–3 months. In the valve replacement and ASD closure groups, complete recovery was not attained during the follow‐up period of 7 days. The findings in this study indicate that, compared with the role of anaesthesia, the role of operative procedure is decisive in the decrease of the lymphocytic responses associated with anaesthesia and surgery. The correlation between decreased mitogen responses and different postoperative complications remains to be established.

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