PMID- 35596611
OWN - NLM
STAT- MEDLINE
DCOM- 20221101
LR  - 20230816
IS  - 1525-1594 (Electronic)
IS  - 0160-564X (Linking)
VI  - 46
IP  - 11
DP  - 2022 Nov
TI  - Acquired platelet defects are responsible for nonsurgical bleeding in left 
      ventricular assist device recipients.
PG  - 2244-2256
LID - 10.1111/aor.14319 [doi]
AB  - BACKGROUND: Left ventricular assist devices (LVADs) have been used as a standard 
      treatment option for patients with advanced heart failure. However, these devices 
      are prone to adverse events. Nonsurgical bleeding (NSB) is the most common 
      complication in patients with continuous flow (CF) LVADs. The development of 
      acquired von Willebrand syndrome (AVWS) in CF-LVAD recipients is thought to be a 
      key factor. However, AVWS is seen across a majority of LVAD patients, not just 
      those with NSB. The purpose of this study was to examine the link between 
      acquired platelet defects and NSB in CF-LVAD patients. METHODS: Blood samples 
      were collected from 62 CF-LVAD patients at pre- and 4 post-implantation 
      timepoints. Reduced adhesion receptor expression (GPIbalpha and GPVI) and activation 
      of platelets (GPIIb/IIIa activation) were used as markers for acquired platelet 
      defects. RESULTS: Twenty-three patients experienced at least one NSB episode. 
      Significantly higher levels of platelet activation and receptor reduction were 
      seen in the postimplantation blood samples from bleeders compared with 
      non-bleeders. All patients experienced the loss of high molecular weight monomers 
      (HMWM) of von Willebrand Factor (vWF), but no difference was seen between the two 
      groups. Multivariable logistic regression showed that biomarkers for reduced 
      platelet receptor expression (GPIbalpha and GPVI) and activation (GPIIb/IIIa) have 
      more predictive power for NSB, with the area under curve (AUC) values of 0.72, 
      0.68, and 0.62, respectively, than the loss of HMWM of vWF (AUC: 0.57). 
      CONCLUSION: The data from this study indicated that the severity of acquired 
      platelet defects has a direct link to NSB in CF-LVAD recipients.
CI  - (c) 2022 International Center for Artificial Organ and Transplantation (ICAOT) and 
      Wiley Periodicals LLC.
FAU - Arias, Katherin
AU  - Arias K
AUID- ORCID: 0000-0003-0779-3405
AD  - Fischell Department of Bioengineering, A. James Clark School of Engineering, 
      University of Maryland, College Park, Maryland, USA.
AD  - Department of Surgery, University of Maryland School of Medicine, Baltimore, 
      Maryland, USA.
FAU - Sun, Wenji
AU  - Sun W
AD  - Department of Surgery, University of Maryland School of Medicine, Baltimore, 
      Maryland, USA.
FAU - Wang, Shigang
AU  - Wang S
AD  - Department of Surgery, University of Maryland School of Medicine, Baltimore, 
      Maryland, USA.
FAU - Sorensen, Erik N
AU  - Sorensen EN
AD  - Division of Perioperative Services, University of Maryland Medical Center, 
      Baltimore, Maryland, USA.
FAU - Feller, Erika
AU  - Feller E
AD  - Department of Medicine, University of Maryland School of Medicine, Baltimore, 
      Maryland, USA.
FAU - Kaczorowski, David
AU  - Kaczorowski D
AD  - Department of Surgery, University of Maryland School of Medicine, Baltimore, 
      Maryland, USA.
FAU - Griffith, Bartley
AU  - Griffith B
AD  - Department of Surgery, University of Maryland School of Medicine, Baltimore, 
      Maryland, USA.
FAU - Wu, Zhongjun J
AU  - Wu ZJ
AUID- ORCID: 0000-0003-0807-7195
AD  - Fischell Department of Bioengineering, A. James Clark School of Engineering, 
      University of Maryland, College Park, Maryland, USA.
AD  - Department of Surgery, University of Maryland School of Medicine, Baltimore, 
      Maryland, USA.
LA  - eng
GR  - R01 HL124170/HL/NHLBI NIH HHS/United States
GR  - R01 HL118372/HL/NHLBI NIH HHS/United States
GR  - R01HL124170/HL/NHLBI NIH HHS/United States
GR  - R01HL118372/HL/NHLBI NIH HHS/United States
GR  - R01HL141817/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20220530
PL  - United States
TA  - Artif Organs
JT  - Artificial organs
JID - 7802778
RN  - 0 (von Willebrand Factor)
SB  - IM
MH  - Humans
MH  - *Heart-Assist Devices/adverse effects
MH  - von Willebrand Factor
MH  - Hemorrhage/therapy/complications
MH  - *von Willebrand Diseases/etiology
MH  - Platelet Activation
MH  - *Heart Failure/surgery
OTO - NOTNLM
OT  - acquired platelet defects
OT  - heart failure
OT  - left ventricular assist devices
OT  - mechanical circulatory support
OT  - nonsurgical bleeding
EDAT- 2022/05/22 06:00
MHDA- 2022/11/02 06:00
CRDT- 2022/05/21 04:02
PHST- 2022/04/02 00:00 [revised]
PHST- 2021/09/15 00:00 [received]
PHST- 2022/05/13 00:00 [accepted]
PHST- 2022/05/22 06:00 [pubmed]
PHST- 2022/11/02 06:00 [medline]
PHST- 2022/05/21 04:02 [entrez]
AID - 10.1111/aor.14319 [doi]
PST - ppublish
SO  - Artif Organs. 2022 Nov;46(11):2244-2256. doi: 10.1111/aor.14319. Epub 2022 May 
      30.