Annals of surgery
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A major surgical procedure can impair the delayed hypersensitivity response. This impairment is associated with suppressor cell activity that can alter either afferent or efferent responses. ⋯ A serum factor(s) in an adoptive transfer experiment is also capable of enhancing primary tumor growth. A unifying hypothesis, based predominantly on data from the current literature, is presented in an attempt to elucidate the mechanism by which all forms of major trauma are associated in some patients with "paradoxical" immune suppression.