Hemodialysis with a Dialyzer Loaded with Argatroban May Be Performed in vivo without a Systemic Anticoagulant

Abstract

Background/Aims: Anticoagulation in hemodialysis (HD) patients at high risk of bleeding remains an intractable problem. Simulating endothelial cells by releasing anticoagulant on the membrane may be a promising alternative. Methods: We modified a polyacrylonitrile (PAN) dialyzer by loading argatroban into its membrane and verified its anticoagulation efficiency and its influence on coagulation markers such as activated partial thromboplastin time (aPTT), D-dimer and thrombin-antithrombin complex (TAT) in an animal HD model. Results: All HD sessions with the argatroban dialyzer were completed successfully with either no or minimal fiber clotting. D-dimer was lower in the argatroban group than in the PAN group; TAT and aPTT values were similar in the two groups, which suggests better anticoagulation and a similar influence on the coagulation system. Conclusion: HD with the argatroban dialyzer is feasible, safe and simple, and could be used in patients at high risk of bleeding.

Preparation and characterization of a thrombin inhibitor grafted polyethersulfone blending membrane with improved antithrombotic property

“…The results demonstrated AG dialyzer is effective to use in heparinfree hemodialysis. 29 In this study, we introduced argatroban into PES by acetylating, oxidating and amidation reaction to prepare AG graed polyethersulfone matrix (PES-AG). Then, PES-AG was blended with PES in different proportions to prepare PES/PES-AG membrane.…”