An in vitro method for comparing biocompatibility of materials for extracorporeal circulation

Peek, Giles J; Scott, Richard; Killer, Hilliary M; Firmin, Richard K
March 2002
Perfusion;Mar2002, Vol. 17 Issue 2, p125
Academic Journal
We measured the response of fresh heparinized human blood to recirculation through circuits made of LVA (Portex Industries, Hythe, Kent, UK), SRT (Rehau UK, Langley, Slough, UK) and Tygon[sup TM] S-65-HL (Norton Performance Plastics, Corby, Northants, UK), as control. Circuit construction: 1/2 in. tubing, heat exchanger (Dideco D-720P), Stockert roller pump, just underoccluded, Cincinnati Sub Zero heater, circuit volume of 500 ml. Flow 3.45 l/min, 37°C. Samples: at 10 min, 1, 2, 4 and 6 h. n=5 in each group; 2/5 SRT experiments were stopped at 45 and 60 min due to overpressurization. Results: Baseline activated clotting time (ACT) of 300 s, increasing in all groups as fibrinogen fell to zero with SRT and LVA. Minimum fibrinogen was 1 g/l for Tygon. Absolute thrombocytopenia occurred (SRT and LVA 60 min and Tygon 240 min). International normalized ratio (INR) in both the SRT and LVA circuits increased, but mean increase for Tygon (0.56) was smaller than the other two materials. Plasma free haemoglobin increased in all three materials; the increase was greater in the LVA circuits compared to the control. C5b9 levels increased equally in all groups. Lactoferrin levels rose equally in all groups to a maximum at 150 min. The neutrophil counts fell, mirroring the lactoferrin. The total white cell counts also fell in all groups; in the LVA circuits, the fall was significantly lower than in the control. Rapid disappearance of platelets and fibrinogen from the blood in the SRT and LVA circuits excludes them both from extracorporeal use. Paradoxically, SRT caused the least complement activation of the three materials. This method can be used to compare biocompatibility.


Related Articles

  • Effects of heparin coating on the expression of CD11b, CD11c and CD62L by leucocytes in extracorporeal circulation in vitro. Hogevold, H.E.; Moen, O.; Fosse, E.; Venge, P.; Braten, J.; Andersson, C.; Lyberg, T. // Perfusion;1997, Vol. 12 Issue 1, p9 

    Leucocyte adhesion molecules are involved in the leucocyte--endothelial interaction and in the activation of coagulation and binding of complement and endotoxin. Thus, they are important in inflammation, systemic acute phase reaction, ischaemia reperfusion injury and resistance against...

  • Enoxaparin sodium.  // Reactions Weekly;12/1/2007, Issue 1180, p14 

    The article describes the case of a 55-year-old patient who developed skin and mucosal ulcers that were associated with heparin-induced thrombocytopenia and thrombosis syndrome. The patient, who had a history of grade IV peripheral arterial occlusive disorders, had received perioperative...

  • Vascular Spasm During Heparin-Dihydroergotamine Prophylaxis in a Quadriplegic Patient: Case History. McDowell, Gregory; Blatman, Robert; Stamp, Warren; Joob, Axel; Tegtmeyer, Charles; Kron, Irving L. // Vascular Surgery;May/Jun1989, Vol. 23 Issue 3, p226 

    Lower extremity ischemia occurred in a quadriplegic patient following dihydroergotamine- heparin prophylaxis. Ergotamine should be used with caution in paralyzed patients.

  • Heparin-Coated Extracorporeal Circulation Systems in Heart Surgery. Tagarakis, Georgios I.; Tsilimingas, Nikolaos B. // Recent Patents on Cardiovascular Drug Discovery;Nov2009, Vol. 4 Issue 3, p177 

    Despite the progress accomplished in the field of off-pump heart surgery, the vast majority of cardiac operations are still performed with the use of extracorporeal circulation, otherwise known as "heart-lung machine." This valuable tool, however, is connected with various complications, partly...

  • Intra-arterial Thrombolysis for Postoperative Digital Ischemia: A Case Report. Efanov, Johnny I.; Odobescu, Andrei; Giroux, Marie-France; Harris, Patrick G.; Danino, Michel A. // ePlasty: Open Access Journal of Plastic Surgery;2014, Vol. 14, p206 

    Objective: Surgical repair of digital flexion deformities can result in vascular injuries threatening the viability of the affected digit. While uncommon, these injuries are reported to have a rate as high as 0.8% following palmo-digital fasciectomy for Dupuytren's disease. Late presentation of...

  • In vitro evaluation of new surface coatings for extracorporeal circulation. Baksaas, S.T.; Videm, V.; Fosse, E.; Karlsen, H.; Pedersen, T.; Mollnes, T.E.; Hagve, T.A.; Svennevig, J.L. // Perfusion;1999, Vol. 14 Issue 1, p11 

    Cardiopulmonary bypass (CPB) exposes blood to large, foreign surfaces. This exposure may activate the cellular and humoral inflammatory systems, resulting in inflammatory reactions and organ dysfunction. Coating the inner surfaces of the bypass circuit may help alleviate these side-effects. The...

  • Monitoring high-dose heparin levels by ACT and HMT during extracorporeal circulation: diagnostic accuracy of three compact monitors. Giavarina, Davide; Carta, Mariarosa; Fabbri, Alessandro; Manfredi, Jacopo; Gasparotto, Edoardo; Soffiati, Giuliano // Perfusion;Jan2002, Vol. 17 Issue 1, p23 

    The correct monitoring of heparin therapy and its reversal determines the successful conduct of cardiovascular surgery with extracorporeal circulation (ECC). The activated coagulation time (ACT) and the heparin management test (HMT) are the most frequently used tests in the operating room. Three...

  • No vasodilator response to low-dose heparin in the forearm skeletal-muscle vascular bed. Abbink, Evertine J.; de Galan, Bastiaan E.; van Ginneken, Egidia E.; van Rosendaal, Aarnout; Smits, Paul // European Journal of Clinical Pharmacology;Apr2002, Vol. 58 Issue 1, p7 

    Objective. Recent reports show that heparin induces vasodilation. This heparin-induced vasodilation might interfere with the results of vascular studies using the perfused-forearm technique because the arterial catheter is often flushed with a heparin solution in those experiments. Therefore, we...

  • Intracoronary Macrothrombus Formation During Percutaneous Coronary Intervention Despite Optimal Activated Clotting Time Using Bivalirudin: A Case Report. Tadros, George M.; Broder, Kevin; Bachour, Fouad // Angiology;Nov/Dec2005, Vol. 56 Issue 6, p761 

    The occurrence of intracoronary thrombus during percutaneous coronary intervention (PCI) is a well-known complication. It has been estimated that it complicates approximately 6% of all coronary procedures. Patients at highest risk for this complication include those with acute ischemic syndromes...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics