Skip to content
DraconiticResearch
Search Sources API
188,932 studies31 sourcesUpdated 35 min ago
Peer-reviewedCC BY 4.0Cells

Immune Remodeling Across Advanced Heart Failure, LVAD Support, and Heart Transplantation: From Cellular Activation to Tissue-Resident Memory

  • Zbigniew Krasiński1
  • Tomasz Urbanowicz2,3,4
  • Mariusz Kowalewski3,4,5
  • Giuseppe Maria Raffa4,6
  • Beata Krasińska7
  • Calogera Pisano4,6
  • Paolo Manca4,6
  • Mansur Rahnama8
  • Piotr Suwalski5
  • Krzysztof Gosik9
  • Ewelina Grywalska9
9 affiliations
  1. 1Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Science, ½ Dluga Street, 61-848 Poznan, Poland
  2. 2Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, ½ Długa, 61-848 Poznań, Poland
  3. 3Thoracic Research Center, Collegium Medicum, Nicolaus Copernicus University, 85-090 Bydgoszcz, Poland
  4. 4Department of Precision Medicine in Medical Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, 90134 Palermo, Italy
  5. 5Department of Cardiac Surgery, Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior, 137 Wołowska Street, 02-507 Warszawa, Poland
  6. 6Department of Research, IRCCS ISMETT, Via Ernesto Tricomi, 5, 90127 Palermo, Italy
  7. 7Department of Hypertensiology, Angiology, and Internal Medicine, Poznan University of Medical Sciences, ½ Dluga Street, 61-848 Poznań, Poland
  8. 8Department of Dental Surgery, Medical University of Lublin, 6 Chodźki Street, 20-093 Lublin, Poland
  9. 9Department of Experimental Immunology, Faculty of Medical Sciences, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland
Open at sourceDOICite

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.

Related

  1. CLEC4E deletion in cardiac resident cells reduces infarct size and improves cardiac remodeling following myocardial ischemia-reperfusion injury
    Michiel Algoet, Ming Wu, Hilde Gillijns +10
    Experimental Biology and MedicinePeer-reviewedCC BYFull textGeneral medicineDOAJ
  2. Urinary Single-Cell Transcriptomics in Kidney Transplantation: Elucidation of Donor–Recipient Cellular Dynamics and Fibrogenic Stress
    Thangamani Muthukumar, Aziz Belkadi, Carol Li +15
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant SurgeonsPeer-reviewedLicence not statedFull text1 citedSurgery & anaesthesiaPMC
  3. Adverse Graft Remodeling Reflects Dynamic Allograft Stress and Predicts Adverse Outcomes After Heart Transplantation
    K. Patel, T. Pan, S. Al-Kindi +6
    medRxivPreprintAll rights reservedFull textSurgery & anaesthesiamedRxiv
  4. Right ventricular remodeling after veno-venous extracorporeal membrane oxygenation bridge to lung transplantation in adults with severe lung disease
    Christian O’Donnell, Bettia Celestin, Jose Rios-Monterrosa +7
    JHLT openPeer-reviewedCC BY-NC-NDFull textSurgery & anaesthesiaEurope PMC
  5. Late-onset Acute Cellular Rejection after Lung Transplantation Triggered by a Fluctuation in the Tacrolimus Trough Level Which Was Successfully Treated with Steroid Pulse Therapy
    Ayaka Sugiura, Kensuke Kanaoka, Maiko Naito +8
    Internal MedicinePeer-reviewedCC BY-NC-NDFull textSurgery & anaesthesiaJ-STAGE

Cite

BibTeXRIS
BibTeX
@article{krasinski2026immune,
  title = {{Immune Remodeling Across Advanced Heart Failure, LVAD Support, and Heart Transplantation: From Cellular Activation to Tissue-Resident Memory}},
  author = {Zbigniew Krasiński and Tomasz Urbanowicz and Mariusz Kowalewski and Giuseppe Maria Raffa and Beata Krasińska and Calogera Pisano and Paolo Manca and Mansur Rahnama and Piotr Suwalski and Krzysztof Gosik and Ewelina Grywalska},
  journal = {Cells},
  year = {2026},
  month = oct,
  doi = {10.3390/cells15211918},
  url = {https://www.mdpi.com/2073-4409/15/21/1918},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Immune Remodeling Across Advanced Heart Failure, LVAD Support, and Heart Transplantation: From Cellular Activation to Tissue-Resident Memory
AU  - Zbigniew Krasiński
AU  - Tomasz Urbanowicz
AU  - Mariusz Kowalewski
AU  - Giuseppe Maria Raffa
AU  - Beata Krasińska
AU  - Calogera Pisano
AU  - Paolo Manca
AU  - Mansur Rahnama
AU  - Piotr Suwalski
AU  - Krzysztof Gosik
AU  - Ewelina Grywalska
PY  - 2026
DA  - 2026/10/22
JO  - Cells
DO  - 10.3390/cells15211918
UR  - https://www.mdpi.com/2073-4409/15/21/1918
AB  - 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.
SN  - 2073-4409
ER  -