Role of contact system activation in hemodialyzer-induced thrombogenicity

Frank, Rolf Dario; Weber, J.; Dresbach, Heike; Thelen, H.; Weiß, Claudia; Floege, Jürgen

doi:10.1046/j.1523-1755.2001.00009.x

Cited by 80 publications

(67 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Initially it was thought that clotting in the dialyzer was due to the deposition of plasma proteins on the dialyzer surface, in particular high-molecular-weight kininogen, prekallikrein and factor XII that are involved in contact activation of coagulation and the fibrinolytic system [13]. Clotting on dialyzer membranes is now thought to be more dependent upon activation of platelets and white blood cells, typically activated monocytes [14].…”

Section: Discussionmentioning

confidence: 99%

Dialyzers Designed to Increase Internal Filtration Do Not Result in Significantly Increased Platelet Activation and Thrombin Generation

et al. 2010

View full text Add to dashboard Cite

Introduction: To increase middle molecule clearances, high-flux dialyzers with increased internal filtration have been developed. However, dialyzer design and structure may affect thrombin generation and platelet activation, thereby risking increased clotting and reduced dialyzer clearances. Methods: Coagulation parameters, platelet, white cell and endothelial activation markers were measured prior to and following dialysis sessions in 12 patients using two different dialyzers designed for increased internal filtration. Results: Prior to dialysis, patients had evidence of activation of coagulation with increased factor VIII:C, thrombin-antithrombin complexes and prothrombin fragment 1+2, increased platelet activation, with raised platelet factor 4, β-thromboglobulin levels and increased fibrinolysis (raised D-dimers). Dialysis was associated with the release of soluble platelet integrin, sP selectin, increased endothelial activation with increased levels of von Willebrand factor (vWF) antigen (vWF:Ag) and vWF propeptide (vWF:pp) and sE selectin. There was no difference in tinzaparin levels at the end of the dialysis session using either dialyzer, as shown by anti-Xa activity – 0.145 ± 0.027 versus 0.11 ± 0.017 IU/ml, respectively. Conclusion: Haemodialysis patients have an inflammatory phenoytype, characterized by increased activation of coagulation, platelets and also fibrinolysis. However, dialyzers designed to increase internal filtration did not significantly increase platelet activation or thrombin generation.

show abstract

Section: Discussionmentioning

confidence: 99%

Dialyzers Designed to Increase Internal Filtration Do Not Result in Significantly Increased Platelet Activation and Thrombin Generation

et al. 2010

View full text Add to dashboard Cite

show abstract

“…The complement activation parameters (C3a and C5b-9) were much higher for BC compared with the other materials, for both 4 and 6 mm tubes. Cellulose is known to induce complement activation in hemodialysis membranes (Frank et al, 2001). The mechanisms underlying these results for BC are still unclear and require further investigation.…”

Section: Complement Activationmentioning

confidence: 99%

Molecular Understanding of Endothelial Cell and Blood Interactions with Bacterial Cellulose: Novel Opportunities for Artificial Blood Vessels

Fink¹,

Sellborn²,

Krettek³

2012

Atherogenesis

View full text Add to dashboard Cite

Atherogenesis 162 What is the ideal vascular graft?Several issues demand consideration when constructing a vascular graft: the mechanical properties of the graft must resemble those of a native blood vessel, and the graft must be biocompatible with its host. One important factor is compliance, i.e., how well the vessel withstands pressure from the bloodstream and whether it can maintain systemic pressure in the vascular system. Vascular grafts should also be "invisible" to the immune system and possess non-thrombogenic properties. One interesting option is bacterial cellulose (BC), whose unique properties (strength, good integration into host tissue and flexibility that allows production in various shapes and sizes) make it an exciting candidate for vascular graft material. The most abundant biopolymer on earth, cellulose is insoluble in water and degradable by microbial enzymes. Several organisms such as plants, algae and bacteria can produce BC. Some members of the bacterial genus Acetobacter, especially Gluconacetobacter xylinum, synthesize and secrete cellulose extracellularly. The network structure of cellulose fibrils resembles that of collagen in the extracellular matrix (ECM). This chapter describes how BC interacts with human endothelial cells (EC) and blood. Specifically, we will evaluate whether surface modifications could promote adhesion of EC and also whether BC's thrombogenic properties compare favorably with conventional graft materials. These properties are critical because materials intended as vascular grafts must satisfy many important features, including blood compatibility, cell interactions and mechanical properties.

show abstract

“…On the one hand, they can prevent the direct contact between blood and membrane to increase the biocompatibility of the dialysis system [11][12][13][14] , and on the other hand, accumulation of large amounts of proteins on the membrane may block the pores of the dialysis membrane, reducing the transfer capability. Besides, they will also lead to a variety of pathological and physiological reactions such as blood coagulation, activation of complement and fibrinolytic systems, and enhanced activity of inflammatory factors [15] . Thus, the removal of excessive adhered proteins on dialysis membranes, while maintaining blood compatibility, is an important issue.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Molecular Mechanism of Adhesion Proteins on Reused Hemodialysis Membranes

Yang

Zhu

2009

Blood Purif

View full text Add to dashboard Cite

In order to study the mechanism of protein adhesion on the Fresenius F6 polysulfone membrane dialyzer, two-dimensional gel electrophoresis, LC-ESI-MS/MS and bioinformatics methods were used to analyze the protein which adhered to the dialyzer membrane. Six of the adhered proteins account for more than 50% of the total 179 proteins, i.e. ficolin precursor, complement C3 precursor, 3 variants of MASP1 and albumin. The results also showed that easily adhered proteins have a greater percentage of acidic amino acids (p < 0.01). The isoelectric point of the 20 proteins with the most deposits is 6.2 ± 1.08, which is obviously lower than of those with the least deposits (7.56 ± 1.36, p < 0.01). The dipole moment of a polysulfone membrane molecule has a tendency to absorb molecules with a negative charge. These results are of significance in understanding and improving membrane protein interactions.

show abstract

Role of contact system activation in hemodialyzer-induced thrombogenicity

Abstract: Our data challenge the common assumption that activation of the contact system with generation of FXIIa is the main trigger for coagulation and thrombus formation in hemodialysis. Only the negatively charged AN69 membrane with enhanced thrombogenicity strongly induced contact activation.

Cited by 80 publications

References 51 publications

Dialyzers Designed to Increase Internal Filtration Do Not Result in Significantly Increased Platelet Activation and Thrombin Generation

Dialyzers Designed to Increase Internal Filtration Do Not Result in Significantly Increased Platelet Activation and Thrombin Generation

Molecular Understanding of Endothelial Cell and Blood Interactions with Bacterial Cellulose: Novel Opportunities for Artificial Blood Vessels

Characteristics and Molecular Mechanism of Adhesion Proteins on Reused Hemodialysis Membranes

Contact Info

Product

Resources

About