{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T17:49:00Z","timestamp":1789753740021,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T00:00:00Z","timestamp":1576540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL118372 R01HL124170 R01HL141817"],"award-info":[{"award-number":["R01HL118372 R01HL124170 R01HL141817"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL141817"],"award-info":[{"award-number":["R01HL141817"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this study was to examine the impact of the nonphysiological shear stress (NPSS) on platelet hemostatic function relevant to thrombosis and bleeding in mechanically assisted circulation. Fresh human blood was circulated for four hours in in vitro circulatory flow loops with a CentriMag blood pump operated under a flow rate of 4.5\u00a0L\/min against three pressure heads (70 mm\u00a0Hg, 150 mm\u00a0Hg, and 350 mm\u00a0Hg) at 2100, 2800, and 4000 rpm, respectively. Hourly blood samples from the CentriMag pump\u2010assisted circulation loops were collected and analyzed for glycoprotein (GP) IIb\/IIIa activation and receptor shedding of GPVI and GPIb\u03b1 on the platelet surface with flow cytometry. Adhesion of platelets to fibrinogen, collagen, and von Willebrand factor (VWF) of the collected blood samples was quantified with fluorescent microscopy. In parallel, mechanical shear stress fields within the CentriMag pump operated under the three conditions were assessed by computational fluid dynamics (CFD) analysis. The experimental results showed that levels of platelet GPIIb\/IIIa activation and platelet receptor shedding (GPVI and GPIb\u03b1) in the blood increased with increasing the circulation time. The levels of platelet activation and loss of platelet receptors GPVI and GPIb\u03b1 were consistently higher with higher pressure heads at each increasing hour in the CentriMag pump\u2010assisted circulation. The platelet adhesion on fibrinogen increased with increasing the circulation time for all three CentriMag operating conditions and was correlated well with the level of platelet activation. In contrast, the platelet adhesion on collagen and VWF decreased with increasing the circulation time under all the three conditions and was correlated well with the loss of the receptors GPVI and GPIb\u03b1 on the platelet surface, respectively. The CFD results showed that levels of shear stresses inside the CentriMag pump under all three operating conditions exceeded the maximum level of shear stress in the normal physiological circulation and were strongly dependent on the pump operating condition. The level of platelet activation and loss of key platelet adhesion receptors (GPVI and GPIb\u03b1) were correlated with the level of NPSS generated by the CentriMag pump, respectively. In summary, the level of NPSS associated with pump operating condition is a critical determinant of platelet dysfunction in mechanically assisted circulation.<\/jats:p>","DOI":"10.1111\/aor.13609","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T01:40:02Z","timestamp":1576633202000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["The impact of shear stress on device\u2010induced platelet hemostatic dysfunction relevant to thrombosis and bleeding in mechanically assisted circulation"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3716-3156","authenticated-orcid":false,"given":"Zengsheng","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiafeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tieluo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartley P.","family":"Griffith","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0807-7195","authenticated-orcid":false,"given":"Zhongjun J.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine Baltimore Maryland"},{"name":"Fischell Department of Bioengineering, A. 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