Achieving Totally Local Anticoagulation on Blood Contacting Devices

Abstract

The recent years have witnessed an increased activity in biocompatibility research aimed at limiting biomaterial-induced blood coagulation. From 2008 to 2016, a total of $36,946,764.00 USD was awarded in grants to 213 research proposals and as large as 50.4% ($18,627,854.00) of that award monies were distributed to 101 proposals over the fiscal years of FY14 to FY16 alone. However, the complexity in blood responses to biomaterials, variability in blood function between individuals and animal species, and differences in medical device application and test setting all continue to pose difficulties in making a breakthrough in this field. This review focuses on the remaining challenges in the context of biomaterial surface interaction with blood, biomaterial properties and their influence on coagulation, old and new surface anticoagulation methods, main test systems (complement and platelet function) for evaluating those methods, limitations of modification techniques, and the current state of systemic anticoagulation usage as adjunctive therapy for controlling blood coagulation on biomaterials. Finally, we propose ingredients necessary for advancing the field towards achieving totally local surface anticoagulation on blood contacting devices including standardization of in vitro and in-vivo test methods. Some highlights of recent forwardlooking work and articles on local anticoagulation are also presented.

Polydopamine/poly(sulfobetaine methacrylate) Co-deposition coatings triggered by CuSO4/H2O2 on implants for improved surface hemocompatibility and antibacterial activity

“…are widely used in clinical practice as implanted biological materials [ [1] , [2] , [3] ]. However, due to their materials natural hydrophobicity, these are prone to non-specific proteins adsorption and adhesion/activation of platelets, further leading to clotting and thrombus to cause device failure [ 4 , 5 ]. What's more serious is that bacteria easily adhere to the surface during catheter implantation.…”

Artificial Lungs: Current Status and Future Directions

“…Novel approaches under investigation include the immobilization of zwitterionic molecules that mimic the exterior of cell membranes as well as the use of nitric oxide producing materials that inhibit platelet activation [38][39][40][41][42][43][44]. It should be noted that surface modification for improved hemocompatibility is a vast topic only briefly touched upon here but discussed more thoroughly elsewhere [45]. Thrombotic complications are likely the largest challenge to the long-term use of artificial lungs.…”

Engineering Approaches to Prevent Blood Clotting from Medical Implants

“…These cells, when healthy, provide a number of important uses, including preventing coagulation. When these cells are damaged, the surface where the damage occurred becomes thrombotic and the clotting cascade is initiated [ 10 ] ( Figure 1 ).…”