Minimodule dialyser for quantitative ex vivo evaluation of membrane haemocompatibility in humans: comparison of acrylonitrile copolymer, cuprophan and polysulphone hollow fibres

Platelet GPIIb/IIIa Is Activated and Platelet-Leukocyte Coaggregates Formed in vivo during Hemodialysis

“…These findings would mean that the stimuli causing the degranulation of platelets persist longer than the stimuli causing the conformational activation of GPIIb/IIIa during hemodialysis. Platelet activation during hemodialysis may be due to many factors, including shear stress, contact activation and agonist activation [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11]. Further examination is still needed to elucidate the more precise mechanism of platelet activation during hemodialysis.…”

“…During hemodialysis, the contact of blood with the prosthetic devices and the interaction of blood and artificial membranes result in platelet activation and a decrease in platelet cell count [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11]. The degree of platelet activation depends on the flow design of the dialysis membrane used [1, 2], the composition and geometry of the dialysis membrane [3, 4, 5, 6, 7, 8, 9, 10], and on rheological factors derived from blood circulation [11].…”

“…The degree of platelet activation depends on the flow design of the dialysis membrane used [1, 2], the composition and geometry of the dialysis membrane [3, 4, 5, 6, 7, 8, 9, 10], and on rheological factors derived from blood circulation [11]. In association with platelet activation, GPIIb/IIIa (CD41/CD61) is converted from a resting form into an activated form, in which its ligand-binding sites are exposed [12, 13, 14].…”

“…While some studies have reported the advantage of some synthetic membranes over cellulosic membranes in terms of platelet activation and platelet-leukocyte coaggregate formation [3, 4, 5, 6, 7, 26, 28], others have shown no differences in this regard [8, 9, 10]. Moreover, the tests used to study platelet function in clinical settings have their own limitations [15].…”

The Failing Heart, the Post-Bypass Heart and the Hemofiltering Artificial Kidney

“…Among potential candidates are complement frag ments C3a and C5a which are known to be very powerful triggers for the release of interleukin-lp [23]. These fragments are widely removed by sev eral types of hemofilters, particularly by polyacry lonitrile membranes [24], Several studies have demonstrated removal of various inflammatory mediators by hemofiltration performed cither during or following CPB [3,4,9]. Nevertheless, the exact implication of this removal remains unclear and there are numerous strong arguments to believe that it is too limited to induce improve ments as important as those observed in hemody namics, blood loss and respiratory functions among these studies [21,25], Even if the identifi cation of these factors requires further investiga tions the technique of hemofiltration is now rou tinely used in most centers performing pediatric cardiac surgery.…”