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Alterations in select immunologic parameters following total artificial heart implantation
Artificial Organs
|February 1, 1987
Summary
Total artificial heart recipients experienced temporary complement activation and lymphopenia. Long-term survivors showed altered T cell populations and intravascular hemolysis, potentially impacting immunocompetence.
Area of Science:
- Immunology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Total artificial hearts (TAH) are used as a bridge to transplantation.
- Understanding the immunologic impact of TAH is crucial for patient outcomes.
Observation:
- Transient complement activation (C3a des Arg increase) occurred postoperatively in all three TAH recipients.
- Long-term survivors exhibited recurrent C3a des Arg elevation linked to intravascular hemolysis due to high blood shear rates.
- Marked lymphopenia and fluctuations in total lymphocyte counts were observed immediately postoperatively.
Findings:
- Progressive decline in helper/inducer T cells and increase in activated suppressor/cytotoxic T cells noted in long-term survivors.
- B cell numbers decreased, but immunoglobulin levels (IgG, IgM) remained stable.
- Neutrophil functions (phagocytosis, respiratory burst) were unaffected.
Implications:
- TAH implantation significantly alters immune cell populations, particularly T cells.
- These immunologic changes may affect immunocompetence during long-term TAH use.
- Further research is needed to clarify the mechanisms and clinical significance of these immune alterations.