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Mechanical shear stress and leukocyte phenotype and function: Implications for ventricular assist device development and use / Gemma Radley; Sabrina Ali; Ina Laura Pieper; Catherine A Thornton
The International Journal of Artificial Organs, Start page: 039139881881732
Swansea University Author: Thornton, Catherine
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Heart failure (HF) remains a disease of ever increasing prevalence in the modern world. Patients with end-stage HF are being referred increasingly for mechanical circulatory support (MCS). MCS can assist patients who are ineligible for transplant and stabilise eligible patients prior to transplantat...
|Published in:||The International Journal of Artificial Organs|
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Heart failure (HF) remains a disease of ever increasing prevalence in the modern world. Patients with end-stage HF are being referred increasingly for mechanical circulatory support (MCS). MCS can assist patients who are ineligible for transplant and stabilise eligible patients prior to transplantation. It is also used during cardiopulmonary bypass (CPB) surgery to maintain circulation whilst operating on the heart. Whilst MCS can stabilise HF and improve quality of life, complications such as infection and thrombosis remain a common risk. Leukocytes can contribute to both of these complications. Contact with foreign surfaces and the introduction of artificial mechanical shear stress can lead to activation of leukocytes, reduced functionality, and the release of pro-inflammatory and pro-thrombogenic microparticles. Assessing the impact of mechanical trauma to leukocytes is largely overlooked in comparison to red blood cells and platelets. This review provides an overview of the available literature on the effects of in vitro to clinical MCS systems on leukocyte phenotype and function. One purpose of this review is to emphasise the importance of studying mechanical trauma to leukocytes to better understand the occurrence of adverse events during MCS.
Flow cytometry; leukocytes; shear stress; ventricular assist devices
Swansea University Medical School