{
  "abstract": "Advanced heart failure (HF) left ventricular assist device (LVAD) support and heart transplantation (HTx) are commonly considered distinct clinical stages, although each occurs within an immune system shaped by preceding inflammatory and antigenic exposures. This review introduces the concept of the recipient immune biography, describing the cumulative immunological history that accompanies patients from advanced HF through mechanical circulatory support to transplantation. We examine how HF-associated innate and adaptive immune activation may be modified by mechanical unloading while simultaneously being reshaped by blood–device interactions, hemolysis, complement activation, infection, transfusion, and sensitization during LVAD support. Following transplantation, this preconditioned immune repertoire encounters persistent donor alloantigen through direct, indirect, and semidirect allorecognition. We integrate T-cell effector, regulatory, exhaustion-associated, and memory states with T follicular helper–B-cell interactions, plasma-cell persistence, donor-specific antibodies, and tissue-resident immunity. Emphasis is placed on the limitations of peripheral biomarkers for representing graft-localized immune processes. We propose a Longitudinal Immune Trajectory integrating serial peripheral biomarkers with cellular, clonal, molecular, and spatial profiling to reconstruct patient-specific immune remodeling across the HF–LVAD–HTx continuum.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Science, ½ Dluga Street, 61-848 Poznan, Poland",
    "Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, ½ Długa, 61-848 Poznań, Poland",
    "Thoracic Research Center, Collegium Medicum, Nicolaus Copernicus University, 85-090 Bydgoszcz, Poland",
    "Department of Precision Medicine in Medical Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, 90134 Palermo, Italy",
    "Department of Cardiac Surgery, Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior, 137 Wołowska Street, 02-507 Warszawa, Poland",
    "Department of Research, IRCCS ISMETT, Via Ernesto Tricomi, 5, 90127 Palermo, Italy",
    "Department of Hypertensiology, Angiology, and Internal Medicine, Poznan University of Medical Sciences, ½ Dluga Street, 61-848 Poznań, Poland",
    "Department of Dental Surgery, Medical University of Lublin, 6 Chodźki Street, 20-093 Lublin, Poland",
    "Department of Experimental Immunology, Faculty of Medical Sciences, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zbigniew Krasiński",
      "orcid": "0000-0002-2798-1959"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Tomasz Urbanowicz",
      "orcid": "0000-0001-8080-2764"
    },
    {
      "affs": [
        2,
        3,
        4
      ],
      "name": "Mariusz Kowalewski",
      "orcid": "0000-0002-5478-3245"
    },
    {
      "affs": [
        3,
        5
      ],
      "name": "Giuseppe Maria Raffa",
      "orcid": "0000-0001-7141-2561"
    },
    {
      "affs": [
        6
      ],
      "name": "Beata Krasińska",
      "orcid": "0000-0002-3464-1645"
    },
    {
      "affs": [
        3,
        5
      ],
      "name": "Calogera Pisano"
    },
    {
      "affs": [
        3,
        5
      ],
      "name": "Paolo Manca"
    },
    {
      "affs": [
        7
      ],
      "name": "Mansur Rahnama"
    },
    {
      "affs": [
        4
      ],
      "name": "Piotr Suwalski"
    },
    {
      "affs": [
        8
      ],
      "name": "Krzysztof Gosik"
    },
    {
      "affs": [
        8
      ],
      "name": "Ewelina Grywalska"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cheejk6x6t32e.bib",
  "cited_by": 0,
  "doi": "10.3390/cells15211918",
  "fulltext_url": null,
  "id": "cheejk6x6t32e",
  "issns": [
    "2073-4409"
  ],
  "landing_url": "https://www.mdpi.com/2073-4409/15/21/1918",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Transplantation: Methods and Outcomes"
    ]
  ],
  "openalex": "W7223173076",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-22",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/cheejk6x6t32e.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:02Z",
      "native_id": "10.3390/cells15211918",
      "source": "crossref",
      "url": "https://www.mdpi.com/2073-4409/15/21/1918"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Transplantation: Methods and Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "Immune Remodeling Across Advanced Heart Failure, LVAD Support, and Heart Transplantation: From Cellular Activation to Tissue-Resident Memory",
  "title_text": "Immune Remodeling Across Advanced Heart Failure, LVAD Support, and Heart Transplantation: From Cellular Activation to Tissue-Resident Memory",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:02Z",
  "url": "https://research.draconitic.com/paper/cheejk6x6t32e",
  "venue": "Cells",
  "versions": []
}