T cell dysfunction and patient age are associated with poor outcomes after mechanical circulatory support device implantation

Joanna M. Schaenman, Maura Rossetti, Yael Korin, Tiffany Sidwell, Victoria Groysberg, Emily Liang, Sitaram Vangala, Nicholas Wisniewski, Eleanor Chang, Maral Bakir, Galyna Bondar, Martin Cadeiras, Murray Kwon, Elaine F. Reed, Mario Deng

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Immunologic impairment may contribute to poor outcomes after implantation of mechanical circulatory support device (MCSD), with infection often as a terminal event. The study of immune dysfunction is of special relevance given the growing numbers of older patients with heart disease. The aim of the study was to define which immunologic characteristics are associated with development of adverse clinical outcomes after MCSD implantation. We isolated peripheral blood mononuclear cells (PBMC) from patients pre- and up to 20 days post-MCSD implantation and analyzed them by multiparameter flow cytometry for T cell dysfunction, including terminal differentiation, exhaustion, and senescence. We used MELD-XI and SOFA scores measured at each time point as surrogate markers of clinical outcome. Older patients demonstrated increased frequencies of terminally differentiated T cells as well as NKT cells. Increased frequency of terminally differentiated and immune senescent T cells were associated with worse clinical outcome as measured by MELD-XI and SOFA scores, and with progression to infection and death. In conclusion, our data suggest that T cell dysfunction, independently from age, is associated with poor outcomes after MCSD implantation, providing a potential immunologic mechanism behind patient vulnerability to multiorgan dysfunction and death. This noninvasive approach to PBMC evaluation holds promise for candidate evaluation and patient monitoring.

Original languageEnglish (US)
Pages (from-to)203-212
Number of pages10
JournalHuman Immunology
Issue number4
StatePublished - Apr 2018
Externally publishedYes


  • Elderly
  • Immune phenotype
  • Mechanical circulatory support
  • T cell

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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