Cellulose-based haemodialysis membranes: Biocompatibility and functional performance compared

Abstract

Regenerated cellulose membranes are widely used in the treatment of renal failure. The presence of hydroxyl (OH) groups on the membrane surface plays an important role in initiating complement activation and also influences thrombogenicity. The OH groups may be masked or reduced by alteration of the manufacturing process of the membrane. We have undertaken a clinical study of four cellulose-based membranes (Cuprophan, Hemophan, cellulose acetate, and cellulose triacetate) in which the hydroxyl groups of the membrane have been replaced and the magnitude of replacement has varied from less than 1% to greater than 80%, to assess the role that these modifications play in functional performance, biocompatibility (neutropenia, leukocyte activation, anaphylatoxin generation, and hypoxaemia). Our findings indicate that there does not appear to be a straightforward correlation between the numbers of hydroxyl groups replaced and modification of biocompatibility, suggesting that not all hydroxyl groups behave in a similar way.

Biocompatibility of fluorinated polyimide

“…29,30 Activated neutrophils that adhere to the endothelium and then mediate endothelial cell damage through the release of ROS. In the present study, we have indicated that the polyimide membrane reduced the production of the anaphylatoxin C3a compared with that determined in PDMS and PSt.…”

Platelet Adhesion, Contact Phase Coagulation Activation, and C5a Generation of Polyethylene Glycol Acid‐Grafted High Flux Cellulosic Membrane with Varieties of Grafting Amounts

“…It has been suggested that complement activation by cellulosic membranes may be attributable to the hydroxyl groups on the surface ( 20). Complement activation results in the generation of C3a and C5a.…”

Inflammatory Response to Polymeric Materials

“…Cellulosic membranes activate the alternative and classical pathways of complement generating increased plasma levels of the anaphylatoxins C3a and C5a within the first 15 minutes of hemodialysis (Woffindin et al, 1992;Pertosa et al, 1993;Innes et al, 1994). It has been recently described how rapid activation of the complement system by cuprophane membranes is mediated by the classical pathway C3-convertase C4bC2a, suggesting an important role of natural antipolysaccharide antibodies in this activation (Lhotta et al, 1998).…”