Detection of T cell apoptosis after major operations

Abstract

Objective: To detect T cell apoptosis in reduced peripheral lymphocyte counts in patients having major operations. Design: Prospective study. Setting: University hospital, Japan. Subjects: 11 patients having oesophagectomy and 5 having laparoscopic cholecystectomy. Interventions: To investigate T cell apoptosis we detected DNA fragmentation using electrophoresis, and T-cell receptor-gamma (TCR-γ) gene amplification using polymerase chain reaction (PCR) in serum. Main outcome measures: Peripheral lymphocyte count and DNA extracted from the serum preoperatively and on postoperative days 1, 3, 5, and 7. Results: The lymphocyte count decreased significantly until day 5 and then increased in the patients who had had oesophagectomy. DNA fragmentation and PCR products for the TCR-γ variable region gene were found in the serum DNA of 10 patients until day 5. No DNA fragmentation or PCR products were found in the serum of patients who had had laparoscopic cholecystectomy. Conclusion: These results suggest that transient T cell apoptosis occurs after major operations.