Immunologic complications of long-term implantation of a total artificial heart

J Clin Immunol. 1988 Jul;8(4):307-18. doi: 10.1007/BF00916559.


Bacterial infections are a significant complication of long-term total artificial heart implantation. We evaluated the functional capabilities of host defense mechanisms in two patients sustained long-term by a total artificial heart. Although serum complement and polymorphonuclear leukocyte function remained intact, both patients became B and T lymphopenic and there was an initial decrease in the ratio of helper/inducer to suppressor/cytotoxic cells. Histologic examination of their lymphoidal tissue at autopsy further revealed reduced numbers of germinal centers and atrophy of the T lymphocyte-dependent areas. In addition, the reticuloendothelial system was engorged with degenerate erythrocytes. We hypothesize that blockade of the reticuloendothelial system was induced by multiple blood transfusions necessitated by device-associated hemolysis and coagulopathy. This blockade may have led to a progressive loss of content of the antigen-specific lymphoidal elements and, perhaps, to a reduced ability to ingest microbe-antibody complexes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Infections / etiology
  • Bacterial Infections / immunology
  • Complement Activation
  • Heart, Artificial / adverse effects*
  • Humans
  • Immunity, Innate*
  • Leukocyte Count
  • Leukopenia / etiology
  • Leukopenia / immunology
  • Lymph Nodes / pathology
  • Neutrophils
  • Postoperative Complications / etiology
  • Postoperative Complications / immunology*
  • T-Lymphocytes / classification
  • T-Lymphocytes / pathology
  • Time Factors