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While MAC provides short-term (days to weeks) support and long-term (months to years) for the heart and\/or lungs, the blood is inevitably exposed to non-physiological shear stress (NPSS) due to mechanical pumping action and in contact with artificial surfaces. NPSS is well known to cause blood damage and functional alterations of blood cells. In this review, we discussed shear-induced platelet adhesion, platelet aggregation, platelet receptor shedding, and platelet apoptosis, shear-induced acquired von Willebrand syndrome (AVWS), shear-induced hemolysis and microparticle formation during MAC. These alterations are associated with perioperative bleeding and thrombotic events, morbidity and mortality, and quality of life in MCS patients. Understanding the mechanism of shear-induce hemostatic disorders will help us develop low-shear-stress devices and select more effective treatments for better clinical outcomes.<\/jats:p>","DOI":"10.1177\/1076029620982374","type":"journal-article","created":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T07:08:54Z","timestamp":1613200134000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":54,"title":["Device-Induced Hemostatic Disorders in Mechanically Assisted Circulation"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5229-3330","authenticated-orcid":false,"given":"Shigang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartley P.","family":"Griffith","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongjun J.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"},{"name":"Fischell Department of Bioengineering, A. 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