The effect of plasma exchange on lymphocyte suppression after burn.

Circulating mediators have been implicated in the pathophysiology of immunodepression after burn injury, suggesting the beneficial effect of plasma exchange in immunorestoration. In this study, 19 adult patients with a mean burn size of 52.2% of total body surface area and mean age of 33.4 years underwent 51 plasma exchange procedures in five different clinical settings, without complication. The suppressive effect of burn serum was assayed in mixed lymphocyte cultures. The mean (+/- SEM) suppression by burn serum drawn prior to plasma exchange was 61.9% +/- 3.6%, while that following plasma exchange was 27.3% +/- 2.7%. The lymphocyte response decrease 55.1% +/- 4.4% in suppressive activity. The mean duration of improvement in lymphocyte function was 4.8 days. Plasma exchange has a significant beneficial effect in restoring lymphocyte immunocompetence in burned patients in a number of clinical settings.