Original Articles

You have full text access to this OnlineOpen article

Preoperative prediction of postoperative edema and effusion in pediatric cardiac surgery by altered antigen expression patterns on granulocytes and monocytes

  1. Attila Tárnok1,*,
  2. József Bocsi2,
  3. Michal Pipek1,
  4. Pavel Osmancik1,
  5. Günter Valet3,
  6. Peter Schneider1,
  7. Jörg Hambsch1

Article first published online: 14 AUG 2001

DOI: 10.1002/cyto.1135

Issue

Cytometry

Cytometry

Volume 46, Issue 4, pages 247–253, 15 August 2001

Additional Information

How to Cite

Tárnok, A., Bocsi, J., Pipek, M., Osmancik, P., Valet, G., Schneider, P. and Hambsch, J. (2001), Preoperative prediction of postoperative edema and effusion in pediatric cardiac surgery by altered antigen expression patterns on granulocytes and monocytes. Cytometry, 46: 247–253. doi: 10.1002/cyto.1135

Author Information

  1. 1

    Pediatric Cardiology, Heart Center Leipzig GmbH, University Hospital, Leipzig, Germany

  2. 2

    Ist Institute of Pathology, Semmelweis University of Medicine, Budapest, Hungary

  3. 3

    Max-Planck-Institute for Biochemistry, Martinsried Munich, Germany

*Pediatric Cardiology, Cardiac Center Leipzig, University Leipzig, Russenstr.19, D-04289 Leipzig, Germany

Publication History

  1. Issue published online: 26 DEC 2002
  2. Article first published online: 14 AUG 2001
  3. Manuscript Accepted: 17 MAY 2001
  4. Manuscript Received: 17 JAN 2001

Funded by

  • Deutsche Stiftung für Herzforschung
  • Deutsche Herzstiftung
  • Sächsisches Ministerium für Wissenschaft und Kunst

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (150K)

Keywords:

  • cardiopulmonary bypass;
  • adhesion molecules;
  • immunology;
  • data mining;
  • predictive medicine

Abstract

Postoperative edema and effusion (POEE) following cardiopulmonary bypass (CPB) surgery in children retards recovery and may aggravate postpericardiotomy (PPS), capillary leak syndrome (CLS), or multiorgan failure (MOF). Compared with complication-free children, POEE affected children have different preoperative serum levels of circulating cytokines and adhesion molecules. These levels may be used preoperatively to assess POEE, but their determination is time consuming, costly, and a substantial blood volume is required. Altered serum levels of cytokines and adhesion molecules also may be reflected in altered antigen expression on circulating blood leukocytes. The predictive potential of flow cytometric (FCM) leukocyte immunophenotyping was explored as a sensitive and fast method that required small blood samples. Blood samples taken 24 h preoperatively from 49 patients (3–18 years old) were stained with monoclonal antibodies for adhesion molecules (ICAM-1, LFA-1, Mac-1) or constitutive/activation markers (CD4, CD14, CD16, CD25, CD54, CD69, HLA-DR) and measured on a microbead calibrated FCM. Neutrophils, monocytes, and eosinophils from POEE patients express higher preoperative levels of LFA-1, monocytes, HLA-DR, and other activation markers (all P < 0.03). Over 89% of the patients were classified correctly by using two discriminant analysis methods (sensitivity, >76%; specificity, >86%; positive prediction, >80%; negative prediction, >83%). Granulocytes and monocytes of postoperative POEE patients exhibit significant preoperative immune activation, suggesting an increased risk for patients with atopic/allergic predisposition. Surgical trauma and CPB cause additional immune activation, leading to POEE by a summative response. Most patients at risk for POEE can be identified preoperatively by using data pattern analysis on FCM-derived parameters. Cytometry (Comm. Clin. Cytometry) 46:247–253, 2001. © 2001 Wiley-Liss, Inc.

View Full Article (HTML) Get PDF (150K)