The effect of cardiopulmonary bypass on T cells and their subpopulations.

To investigate the effect of cardiopulmonary bypass (CPB) on T cells, lymphocyte subsets of peripheral blood and lymphoid organs were monitored during and after open-heart surgery (Group 1). As a control, lymphocyte subsets of peripheral blood were measured in patients undergoing thoracovascular operations without CPB (Group 2). In Group 1, analysis of each subset-to-total lymphocyte ratio revealed that observed lymphocytopenia in the early postoperative days was mainly the result of T cell reduction, and that the decrease of helper/inducer T cells contributed to this decrease. In contrast, no significant fluctuation of any lymphocyte subpopulation ratio was observed in Group 2. Analysis of lymphocyte subpopulation ratios in lymphoid organs showed that reciprocal changes of T cells and their subsets were observed in the bone marrow, thus indicating that the redistribution of T cells (especially of helper/inducer cells) seems to occur between peripheral blood and bone marrow in Group 1. Furthermore, there was no relationship between serum cortisol levels and the changes in lymphocyte subset ratios in Group 1 patients.