Recent Developments and Current Challenges of Heparin-Grafted Hemodialysis Membranes

Abstract

Hemodialysis (HD) is a life-sustaining extracorporeal blood purifying treatment for end-stage renal disease (ESRD) patients. However, this membrane-based therapy is associated with acute side effects, life-threatening chronic conditions, and unacceptably high morbidity and mortality rates. Numerous surface coatings have been developed to improve the blood compatibility of biomaterials. Heparin is a widely used anticoagulant substance that increases the clotting time and increases the membrane hemocompatibility in terms of platelet adhesion and protein adsorption and anti-clotting activity. However, using heparin is challenging due to its severe or life-threatening side effects such as heparin-induced thrombocytopenia (HIT), in addition to heparin induced thrombocytopenia and thrombosis (HITT). In addition, heparin is strongly electronegative and exhibits a binding affinity for the positive active sites of human serum proteins, which is an additional challenge. Consequently, covalently immobilized heparin would create a more charged surface to induce more blood–membrane interactions, and consequently more adsorbed human serum proteins and biochemical pathway activations, which can negatively affect dialysis patients. Therefore, the current critical review has thoroughly focused on different heparin HD membrane systems, the challenges of heparin-coated dialysis membranes, and the factors affecting its hemocompatibility, in addition to the methods that can be used to enhance its hemocompatibility. Furthermore, this review summarizes the advantages and disadvantages of heparin-grafted methods. Furthermore, the influence of the heparin-immobilization method on the hemocompatibility and performance of the HD membrane was comprehensively analyzed. Finally, we conclude with the future perspectives for the strategies toward the heparinization and heparin-like/mimicking modification of membrane surfaces.

Polymer-Drug Anti-Thrombogenic and Hemocompatible Coatings as Surface Modifications

“…Hemodialysis is a procedure used to treat end-stage renal disease by filtering waste and excess fluid from the blood outside the body [ 110 ]. Dialysis membranes are crucial components in artificial kidneys, as they facilitate the removal of various impurities from the blood of patients with kidney disease [ 111 ].…”

Quality of Life of Dialysis Patients: Exploring the Influence of Membrane Hemocompatibility and Dialysis Practices on Psychosocial and Physical Symptoms

“…We highlighted the main reasons related to membrane chemistry and morphology. Our research group has conducted extensive studies on hemodialysis membrane modification to improve its compatibility [30][31][32][33][34][35][36][37][38][39][40][41]. However, it is crucial to correlate the key factors of membrane compatibility and its morphological structures with the aim of enhancing the quality of life of dialysis patients.…”

Expanding the Scope of an Amphoteric Condensed Tannin, Tanfloc, for Antibacterial Coatings

“…Combining polyanionic GAGs with polycationic TAN can modulate the properties of biomaterials [6]. HEP, a highly negatively charged polymer, inhibits blood coagulation by preventing thrombin activation, making it a valuable component in blood-contacting biomaterials [36,37]. Combining the cationic tannin derivative TAN with HEP in PEMs results in a significant decrease in factor XII activation, platelet adhesion, and activation, enhancing blood compatibility and antibacterial properties on titanium surfaces [38].…”