Postsurgical granulocyte dysfunction: studies in healthy kidney donors

In order to determine whether surgical trauma affects granulocyte function, the authors performed sequential studies of granulocyte phagocytic and bactericidal function, chemotaxis, and adherence on 25 otherwise healthy subjects undergoing donor nephrectomy for kidney transplantation. All values were normal prior to surgery, and bacterial killing and phagocytosis were unaffected by surgery. Granulocyte chemotaxis and adherence were significantly impaired immediately following surgery, returning to normal in 24 hr. Anesthesia alone did not affect chemotaxis. Generation of chemoattractants from postoperative plasma was normal, and inhibitor of chemotaxis could not be demonstrated, suggesting an intrinsic cellular defect. The authors suggest that these postoperative abnormalities of granulocyte chemotaxis and adherence may contribute to the high incidence of infectious complications following surgery.