Studies on the behavior of lymphocytes in the direct lymphocytotoxicity test (DLT) in surgical patients: I. Diagnostic value of the test.

The results of the investigations of immunological reactivity in 120 surgical patients are presented. The direct lymphocytotoxicity test (DLT) was used. Negative results were found in only 20 patients; in the remaining 100, the number of damaged lymphocytes in the peripheral blood, examined in vitro was dependent on: 1) the type of surgical procedure (e.g. open reduction and internal fixation of long-bone fractures), 2) severity of surgical disease, 3) interaction of drugs used, and 4) infection, most probably viral. A high percentage of damaged lymphocytes was found firstly, in patients suffering from severe wound infections; secondly, in those with disorders of the peripheral arteries during the postoperative course and thirdly, in patients with advanced malignancy of the alimentary tract. The results of these investigations--regarded by the authors as a preliminary report--indicate that the DLT could be introduced routinely as part of pre- and postoperative examinations of surgical patients in order to evaluate their immunological reactivity.