Time-dependent cellular population of textured-surface left ventricular assist devices contributes to the development of a biphasic systemic procoagulant.

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Time-dependent cellular population of textured-surface left ventricular assist devices contributes to the development of a biphasic systemic procoagulant response Talia B. Spanier, MD, Jonathan M. Chen, MD, Mehmet C. Oz, MD, David M. Stern, MD, Eric A. Rose, MD, Ann Marie Schmidt, MD The Journal of Thoracic and Cardiovascular Surgery Volume 118, Issue 3, Pages 404-413 (September 1999) DOI: 10.1016/S0022-5223(99)70176-5 Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 1 Enhanced tissue factor activity in peripheral blood monocytes of patients with LVADs. Peripheral blood mononuclear cells were isolated from LVAD patients (n = 5) or from normal control subjects (n = 3), and tissue factor activity assays were performed as described above, alone or in the presence of lipopolysaccharide (LPS) ( 10 μg/mL). Tumor factor activity was then assayed as described in triplicate and reported as the mean ± standard error. *P < .05 by analysis of variance. The Journal of Thoracic and Cardiovascular Surgery 1999 118, 404-413DOI: (10.1016/S0022-5223(99)70176-5) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 2 Elaboration of procoagulant tissue factor and enhancedprocoagulant activity by cells derived from the LVAD surface. A , Cells from the LVAD surface placed onto representative sections of LVAD surface in tissue culture wells or tissue culture plastic in the presence of lipopolysaccharide (LPS) (10 μg/mL). Aliquots were harvested at 6 hours and assayed for tissue factor. Data are reported as percent above control (LVAD-derived cells cultured on tissue culture plastic in the presence or absence of lipopolysaccharide). Black bars represent LVAD-derived cells in the presence of LVAD material. Open bars represent LVAD cells in the presence of LVAD material + lipopolysaccharide (10 μg/mL). *P < .01 compared with controls by analysis of variance. **P < .001 compared with controls by analysis of variance. B , Mononuclear cells from LVAD surface or from controls were isolated as above and exposed to lipopolysaccharide (10 μg/mL) for 6 hours on tissue culture plastic. Tissue factor activity assays performed as described above were then performed as described in triplicate and reported as the mean ± standard error. *P < .05 by analysis of variance. Data are reported as percent above control (peripheral derived mononuclear cells not exposed to lipopolysaccharide, 10 μg/mL). **P < .001 compared with controls by analysis of variance. The Journal of Thoracic and Cardiovascular Surgery 1999 118, 404-413DOI: (10.1016/S0022-5223(99)70176-5) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 3 Immunohistochemical analysis of cells derived from the LVAD surface: cell culture. Cells were harvested from the LVAD surface and placed onto Nunc tissue culture dishes. After 48 to 72 hours in culture, cells were fixed in formalin (10%) and immunohistochemical analysis using specific antibodies to the following was performed as described above: panel A, anti-CD34-immunoglobulin G; panel B (left), anti-CD68-immunoglobulin G; panel B (right), anti-CD14-immunoglobulin G; panel C, anti-tissue factor-immunoglobulin G; panel D (left), smooth muscle actin; panel D (right), nonimmune immunoglobulin G (IgG). (Original magnification: ×100.) The Journal of Thoracic and Cardiovascular Surgery 1999 118, 404-413DOI: (10.1016/S0022-5223(99)70176-5) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 4 Activated cells are present on the LVAD surface: RT-PCR was performed from material directly removed from the LVAD surface at the time of explanation as described above using specific primers. Positive amplicons for the following were identified: A, Interleukin lα (IL-1); B, interleukin 2 (IL-2); C, tumor necrosis factor α (TNF- α); D, vascular cell adhesion molecule-1 (VCAM-1); E, intercellular adhesion molecule-1 (ICAM-1). Markers are indicated on the right-hand side of each panel. The Journal of Thoracic and Cardiovascular Surgery 1999 118, 404-413DOI: (10.1016/S0022-5223(99)70176-5) Copyright © 1999 Mosby, Inc. Terms and Conditions