Immunodeficiency following neonatal thymectomy in man.

Patients undergoing cardiac bypass operations normally have a thymectomy to facilitate cannulation of the great vessels. Laboratory indices of immune function were measured in 18 children aged 9 months to 3 years who had had a thymectomy when aged 3 months or less, and in two groups of controls individually matched for age and age at operation. Total lymphocyte numbers were similar in all three groups but thymectomized children had significantly lower numbers of T cells and T cell sub-sets than controls and showed diminished responses to phytohaemagglutinin and concanavalin A. Children who have had a thymectomy early in life represent an important group in the study of the development of the immune system in man. Although the clinical consequences of early thymectomy are unclear, evidence of impairment of parameters of immunity have been found in later infancy and routine thymectomy in paediatric cardiac surgery should be avoided.