{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:22:43Z","timestamp":1791390163158,"version":"4.3.3"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scand J Immunol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Infants with congenital heart disease (CHD) often undergo thymectomy during corrective cardiac surgery (CCS). The long\u2010term immunological effects remain controversial, with concerns regarding increased susceptibility to infections, allergies, autoimmunity due to compromised immune tolerance mechanisms. This study aims to elucidate the long\u2010term immunological effects of early thymectomy. We enrolled 22 patients who underwent thymectomy in infancy and were followed up in the Pediatric Allergy and Immunology Clinic at Marmara University. We performed demographic characteristics and detailed immunological evaluation, including immunoglobulins, vaccine responses, lymphocyte subset analyses, upregulation, proliferation of T cells and T\u2010cell receptor excision circles (TRECs). Sixteen patients had a history of infection, including six serious infections, all in the first year. Lymphopenia was observed in 27% of patients, with a significant decrease in naive CD4<jats:sup>+<\/jats:sup> and recent thymic emigrant T cells counts and an increase in the proportion of memory T\u2010cells, indicating premature immune senescence. Low levels of IgG, IgA and IgM were found in 36%, 40% and 22% of patients respectively. Vaccine responses were positive in 90% of patients. TREC levels were low in all 10 patients analysed. Seven of nine patients had normal proliferation. Twenty\u2010two percent of patients had allergic disease, and autoimmunity was not observed. Early thymectomy leads to permanent immunological changes that are indicative of early immunosenescence. It is recommended to preserve thymic tissue during surgery and requires long\u2010term follow\u2010up in terms of findings such as allergy and autoimmunity as well as infections due to impaired immune tolerance mechanisms.<\/jats:p>","DOI":"10.1111\/sji.13418","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T16:06:48Z","timestamp":1730304408000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010term immunological changes after corrective cardiac\u00a0surgery"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0561-3343","authenticated-orcid":false,"given":"Sevgi","family":"Bilgic\u2010Eltan","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Institute of Health Sciences, Division of Pediatric Immunology and Allergy and Master's\/Doctoral Program, Jeffrey Modell Primary Immunodeficiency Diagnosis Center, I\u015f\u0131l Barlan Translational Medicine Center, Immunodeficiency Application and Research Center, Faculty of Medicine Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7026-2711","authenticated-orcid":false,"given":"Razin","family":"Amirov","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Immunology and Allergy Marmara University Faculty of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1044-2174","authenticated-orcid":false,"given":"Royale","family":"Babayeva","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Immunology and Allergy Marmara University Faculty of Medicine  Istanbul 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