• Annals of surgery · Dec 2023

    Immune Phenotype and Postoperative Complications following Elective Surgery.

    • Dimitrios Moris, Richard Barfield, Cliburn Chan, Scott Chasse, Linda Stempora, Jichun Xie, Jennifer K Plichta, Julie Thacker, David H Harpole, Todd Purves, Sandhya Lagoo-Deenadayalan, Eun-Sil Shelley Hwang, and Allan D Kirk.
    • Department of Surgery, Duke University; Durham, NC.
    • Ann. Surg. 2023 Dec 1; 278 (6): 873882873-882.

    ObjectivesTo characterize and quantify accumulating immunologic alterations, pre and postoperatively in patients undergoing elective surgical procedures.BackgroundElective surgery is an anticipatable, controlled human injury. Although the human response to injury is generally stereotyped, individual variability exists. This makes surgical outcomes less predictable, even after standardized procedures, and may provoke complications in patients unable to compensate for their injury. One potential source of variation is found in immune cell maturation, with phenotypic changes dependent on an individual's unique, lifelong response to environmental antigens.MethodsWe enrolled 248 patients in a prospective trial facilitating comprehensive biospecimen and clinical data collection in patients scheduled to undergo elective surgery. Peripheral blood was collected preoperatively, and immediately on return to the postanesthesia care unit. Postoperative complications that occurred within 30 days after surgery were captured.ResultsAs this was an elective surgical cohort, outcomes were generally favorable. With a median follow-up of 6 months, the overall survival at 30 days was 100%. However, 20.5% of the cohort experienced a postoperative complication (infection, readmission, or system dysfunction). We identified substantial heterogeneity of immune senescence and terminal differentiation phenotypes in surgical patients. More importantly, phenotypes indicating increased T-cell maturation and senescence were associated with postoperative complications and were evident preoperatively.ConclusionsThe baseline immune repertoire may define an immune signature of resilience to surgical injury and help predict risk for surgical complications.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…