Immunobiologic consequences of assist devices

Silviu Itescu, Michael Schuster, Elizabeth Burke, Jan Ankersmit, Alfred Kocher, Mario Deng, Ranjit John, Katherine Lietz

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations


The aberrant state of monocyte and T-cell activation resulting from these host-device interaction is accompanied by two parallel processes: (1) selective loss of Th1 cytokine-producing CD4 T cells through activation-induced cell death, and (2) unopposed activation of Th2 cytokine-producing CD4 T cells resulting in B-cell hyperreactivity and dysregulated immunoglobulin synthesis via Th2 cytokines and heightened CD40 ligand-CD40 interactions. The net result of these events is that on one hand the VAD recipient develops progressive defects in cellular immunity and is at increased risk of serious infection, and on the other hand the VAD recipient is more likely to develop allosensitization, posing a significant risk to successful transplant outcome.

Original languageEnglish (US)
Pages (from-to)119-133
Number of pages15
JournalCardiology Clinics
Issue number1
StatePublished - Feb 2003
Externally publishedYes


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