Effect of biopassive and bioactive surface‐coatings on the hemocompatibility of membrane oxygenators

Abstract

Postoperative complications associated with cardiopulmonary bypass (CPB) surgery and extracorporeal circulation (ECC) procedures are still a major clinical issue. Improving the hemocompatibility of blood contacting devices used for ECC procedures may ameliorate various postpump syndromes. In a simulated CPB model using human blood, we investigated the hemocompatibility, fibrinogen adsorption, and platelet receptor (GPIIb-IIIa) binding capacity of surface-modified membrane oxygenators (Jostra Quadrox). Three groups were compared: (i) biopassive protein coatings (SafeLine), (ii) bioactive heparin coatings (BioLine), and (iii) noncoated controls. During the 2 h recirculation period, plasma concentrations of activation markers for platelets (beta-thromboglobulin), inflammation (elastase), complement (C5a), and coagulation (prothrombin fragment 1+2, thrombin-antithrombin III) were lower in the groups with biopassive and bioactive coatings compared to the noncoated group (p < 0.01). These parameters did not significantly differ between the two surface-coated groups, except for complement activation: C5a levels were higher in the biopassive group compared to the bioactive group (p < 0.01). Moreover, surface-coated oxygenators showed less fibrinogen adsorption, GPIIb-IIIa binding, and platelet/leukocyte adhesion (p < 0.01). We assume that fewer fibrinogen and platelet receptor molecules bound to the surface-coated oxygenator surfaces results in fewer platelet adhesion and activation, which will significantly contribute to the improved hemocompatibility of the biopassive and bioactive oxygenators. Our results suggest that the application of bioactive oxygenators (BioLine) during CPB surgery may reduce postoperative complications for the patient more effectively than biopassive oxygenators (SafeLine).

The volatile anesthetic sevoflurane inhibits activation of neutrophil granulocytes during simulated extracorporeal circulation

“…According to the manufacturer, Softline® is a polymer comprised of hydrophilic and hydrophobic areas, which reduce adhesion and activation of cells and activation of the coagulation and complement system. Using Softline®-coating, cell activation in ECC is reduced as shown in studies reporting preservation of platelet and leukocyte counts using Softline® and similar circuit-coatings [24,25]. This is further supported by our results showing no statistically significant increases in the formation of leukocyte-platelet aggregates during ex 6.…”

6-Deoxy-6-aminoethyleneamino cellulose: synthesis and study of hemocompatibility

“…Antithrombogenic surfaces are required by several implants and medical devices in contact with the hemostatic system. [21][22][23] Therefore, AEA cellulose with a high DS may provide interesting surface coatings for such medical implants. Taking into consideration that this study based on soluble AEA cellulose in vitro and AEA cellulose attached as coatings on material surfaces of biomedical devices could provide changes in surface patterns and exhibit different properties.…”

ECMO Biocompatibility: Surface Coatings, Anticoagulation, and Coagulation Monitoring

“…Albumin covalently linked to surfaces (e.g., Safeline® by Maquet) ensures its retention and prevents displacement. Research on this coating technique has demonstrated short-term reductions in the concentration of fibrinogen and platelets on the surface and some evidence that it reduces complement activation [11].…”