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December 1988

The Immune-Enhancing Effect of Perioperative Thymopentin Administration in Elderly Patients Undergoing Major Surgery

Author Affiliations

From the Departments of Surgery (Drs Faist, Ertel, and Heberer and Ms Salmen) and Cardiac Surgery (Drs Weiler and Ressel), LM University, Munich; and the Research Unit, Cilag Ltd, Schaffhausen, Switzerland (Dr Bolla).

Arch Surg. 1988;123(12):1449-1453. doi:10.1001/archsurg.1988.01400360019001

• The effects of perioperative administration of thymopentin (TP-5) on in vivo and in vitro measurements of cell-mediated immunity in elderly patients undergoing major surgery were investigated. A placebo-controlled study was conducted in 25 patients (mean age, 67 years) with congenital or acquired heart disease undergoing surgery with cardiopulmonary bypass. Patients were divided into three groups: Group 1 patients were given 50 mg of TP-5 subcutaneously two hours preoperatively. Group 2 patients were given 50 mg of TP-5 subcutaneously two hours preoperatively and 48 hours postoperatively. Group 3 patients were given placebo at corresponding times. Cell-mediated immunity measurements were the in vivo delayed-type hypersensitivity (DTH) response on day 0 and on day 7 to an antigen skin test battery. The in vitro studies included antigen cocktail—induced lymphocyte proliferation of peripheral blood mononuclear cells. The DTH response on day 7 after surgery was significantly suppressed in group 3 patients compared with the preoperative baseline value, while it remained unaltered in group 1 and 2 patients. There was a considerable difference of DTH measurements (number of positive antigen responses and sum of their mean diameters) between group 2 and 3 patients. Antigen cocktail—induced lymphocyte proliferation, following initial suppression in the majority of patients, was significantly different between the placebo group and patients in group 2 on day 7 after surgery. The data indicate that perioperative administration of TP-5 might be of considerable clinical utility in preventing a defective cellular immune response.

(Arch Surg 1988;123:1449-1453)

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