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Richard N. Pierson, MD

Academic Title:

Clinical Professor

Primary Appointment:


Additional Title:

Senior Associate Chair for Research, Department of Surgery Director of Clinical Research, UMSOM Program in Lung Healing


Cardiac Surgery, 110 South Paca Street, 7N-134

Phone (Primary):

(410) 328-5842



Education and Training

BA, Princeton University, English (American Studies), 1978

MD, Columbia University, College of Physicians andSurgeons, 1983

General Surgery Residency, University of Michigan Hospitals, Ann Arbor, Michigan 1983 to 1986 

Postdoctoral Research Scientist,Columbia College of Physicians and Surgeons, 1986 to 1987

Research Fellow in Surgery, Massachusetts General Hospital, Boston, Massachusetts, 1987 to 1988

Fellowship in Cardiothoracic Surgery, Massachusetts General Hospital, Boston, MA, 1990 to  1992

Research and Clinical Fellow in Transplantation, Cambridge University, Cambridge, England, 1993 to 1994

Assistant and Associate Professor of Surgery, Vanderbilt University, 1994 to 2002   

Associate Professor and Professor of Surgery, University of Maryland School of Medicine, 2002-present

Senior Associate Dean for Academic Affairs, Interim Director of Research Affairs, UMSOM, 2011-2013 



     The Pierson/Azimzadeh laboratory explores clinically important questions in transplantation.  Working primarily in a cynomolgus monkey heterotopic heart allograft model, we study the pathogenesis of chronic rejection, and investigate costimulation and innate immune pathway modulation as approaches to induce operational tolerance.  Barriers to successful application of pig-to-human xenotransplantation are studied in lung, heart, kidney, and liver models, focusing on coagulation pathway regulation, costimulation pathway blockade, and cell adhesion mechanisms, as well as composite tissue transplantation as part of a tolerance induction strategy.  Extensive international collaborative interactions support these “translational” research projects.

     My clinical research relates to coagulation pathway control during mechanical circulatory assist device and ECMO support, ex vivo lung perfusion, new cardiac and pulmonary support device testing, and multicenter device and drug trials.  As Director of Clinical Research for the UMSOM Program in Lung Healing, I am the principle architect of a comprehensive clinical database and associated biobank that includes all patients at University of Maryland Medical Center who manifest acute respiratory failure.

    During the course of over 20 years working in the cynomolgus monkey heart transplant and in heart, lung, liver, and kidney xenotransplant models, we have brought together unique technical and scientific expertise in a stable research team, and assembled the deep archive of informative biologic samples necessary to successfully carry out future planned research projects.

Research/Clinical Keywords

Heart transplantation, Lung transplantation, Immunological tolerance, Xenotransplantation, Composite tissue transplantation

Highlighted Publications


Azimzadeh A, Pfeiffer S, Wu G, Schröder C, Zorn G III, Ozkaynak E, Kehry M, Atkinson J, Miller G, Pierson RN III.  Alloimmunity in primate heart recipients with CD154 blockade: evidence for alternative costimulation mechanisms.  Transplantation 2006; 81(2): 255-64. 

Wu G, Pfeiffer S, Schröder C, Zhang T, Nguyen BN, Kelishadi S, Atkinson JB, Schuurman H-J, White DJG, Azimzadeh AM, Pierson RN III.  Coagulation cascade activation triggers early failure of pig hearts expressing human complement regulatory proteins.  Xenotransplantation 2007; 14(1): 34-47.

Poirier N, Azimzadeh AM, Zhang T, Dilek N, Mary C, Nguyen B, Tillou X, Wu G, Reneaudin K, Hervouet J, Martinet B, Coulon F, Allain-Launay E, Karam G, Soulillou J-P, Pierson RN III*, Blancho G*, Vanhove B*.  Inducing CTLA-4–Dependent Immune Regulation by Selective CD28 Blockade Promotes Regulatory T Cells in Organ Transplantation.  Science Translational Medicine 2010; 2 (17): 17ra10.

Mohiuddin M, Singh AK, Corcoran PC, Thomas ML III, Clark T, Lewis B, Hoyt R, Eckhaus M, Pierson RN III, Belli AJ, Wolf E, Klymiuk N, Phelps C, Reimann K, Ayares D, Horvath KA. Chimeric 2C10R4 anti-CD40 antibody therapy is critical for long-term survival of GTKO.hCD46.hTBM pig-to-primate cardiac xenografts.  Nature Communications 2016; 7:11138.

Burdorf L, Riner A, Rybak E, Salles II, De Meyer SF, Shah A, Quinn KJ, Harris D, Zhang T, Parsell D, Ali F, Schwartz E, Kang E, Cheng X, Sievert E, Zhao Y, Braileanu G, Phelps CJ, Ayares DL, Deckmyn H, Pierson RN 3rd, Azimzadeh AM.  Platelet sequestration and activation during GalTKO.hCD46 pig lung perfusion by human blood is primarily mediated by GPIb, GPIIb/IIIa, and von Willebrand Factor.  Xenotransplantation 2016; 23(3): 222-36.

Azimzadeh AM,* Zhang T,* Wu G, Kelishadi SS, Stoddard T,  O’Neill N, Nguyen B-N, Welty E, Avon C, Higuchi M, Mitchell SL, Hershfeld A,  Cheng XF, Kronfli A, Rybak E, Burdorf L, Pierson RN 3rd.  Preemptive CD20+ B cell depletion attenuates cardiac allograft vasculopathy in CD154-treated monkeys.  Transplantation 2017; 101(1): 63-73. 


Additional Publication Citations

Pierson RN III, Winn HJ, Russell PS, Auchincloss H Jr:  Xenogeneic skin graft rejection is especially dependent on CD4+ T cells.  Journal of Experimental Medicine 1989; 170: 991-6.

Pierson RN III, Kasper-Konig W, Tew DN, Young VK, Dunning JJ, Horsley J, Carey NRB, Wallwork J, White DJG:  Hyperacute lung rejection in a pig-to-human transplant model.  1) The role of anti-species antibody and complement.  Transplantation 1997; 63(4): 594-603.

Pierson RN III, Chang AC, Blum MG, Blair KSA, Scott MA, Atkinson JB, Collins BJ, Zhang J-P, Thomas DW, Burkly LC, Miller GG.  Prolongation of primate cardiac allograft survival by treatment with anti-CD 40L (CD154) antibody.  Transplantation 1999; (68): 1800-1822.

Collins BJ, Blum MJ, Parker RE, Chang AC, Blair KSA, Christman BW, Pierson RN III.  Thromboxane mediates pulmonary hypertension and contributes to microvascular injury during hyperacute lung rejection. J. Applied Physiology 2001; 90: 2257-2268.

Wu G, Pfeiffer S, Schröder C, Zhang T, Nguyen BN, Kelishadi S, Atkinson JB, Schuurman H-J, White DJG, Azimzadeh AM, Pierson RN III.  Co-stimulation blockade targeting CD154 and CD28/B7 modulates the induced antibody response after a pig-to-baboon cardiac xenograft.  Xenotransplantation 2005; 12(3): 197-208.

Pierson RN III.  Current Status of Xenotransplantation.  JAMA 2009; 301 (9): 967-9.

Burdorf L, Stoddard T, Zhang T, Rybak E, Riner A, Avon C, Laaris A, Cheng X, Sievert E, Braileanu G, Newton A, Phelps CJ, Ayares D, Azimzadeh AM, Pierson RN 3rd.  Expression of human CD46 modulates inflammation associated with GalTKO lung xenograft injury.  Am J Transplant. 2014; 14(5): 1084-95.

Azimzadeh AM, Kelishadi SS, Ezzelarab MB, Singh AK, Stoddard T, Iwase H, Zhang T, Burdorf L, Sievert E, Avon C, Cheng X, Ayares D, Horvath KA, Corcoran PC, Mohiuddin MM, Barth RN, Cooper DK, Pierson RN 3rd.  Early graft failure of GalTKO pig organs in baboons is reduced by expression of a human complement pathway-regulatory protein.  Xenotransplantation. 2015; 22(4): 310-6.  

Research Interests


Clinical Specialty Details

Thoracic transplantation and mechanical circulatory support

Grants and Contracts

2U01AI066719-12      Pierson, RN III       7/05-6/17

Immunomodulation for Heart Allograft Tolerance:   To study costimulation blockade as a tolerance induction strategy in a primate heart transplant model, with a particular focus on selective inhibition of CD28 combined with transient targeting of ICOS, CD154, and CD20.                  


 1 U19 AI090959-07 Cooper (Pierson, RN III Project 2 PI)     9/10-8/20                    

Genetically-engineered pig organ transplantation into nonhuman primates:    Project 2 uses genetic and pharmacologic approaches to reveal the mechanisms of GalTKO.hCD46 pig lung and liver injury in human blood perfusion and baboon organ xenograft models.         


Sponsored Research Agreement, United Therapeutics

Lung Xenotransplant Tolerance InductionThis three year contract supports translational research to accomplish prolonged life-supporting pig-to-baboon lung xenograft survival, and explore strategies to accomplish immunologic tolerance in this model.