Heparin-mimicking semi-interpenetrating composite membrane with multiple excellent performances for promising hemodialysis

Heparin and heparin-like modifications in hemodialysis membranes: Current innovations and future directions

Heparinized hemodialysis membranes represent a significant advancement in improving the biocompatibility and anticoagulant properties of dialysis treatments. This review explores the current challenges and innovations in developing these membranes, focusing on the incorporation of heparin and heparin-like substances to reduce protein adsorption, platelet adhesion, and clot formation. The methods for heparin immobilization, including covalent bonding, layer-by-layer assembly, and blending, offer promising results in enhancing membrane performance. However, issues such as long-term stability, large-scale production, and cost-effectiveness remain critical barriers to their widespread adoption. The review also highlights the role of surface activation techniques and nanotechnology in improving the functionality of heparinized membranes. Advanced methods like plasma treatment and polymer grafting provide better heparin attachment, while nanomaterial integration allows for improved blood compatibility and controlled heparin release. Despite these innovations, challenges such as heparin degradation, uneven coating, and the complexity of scaling up remain unresolved. Future research should focus on optimizing heparin distribution, enhancing durability, and making the production process more cost-efficient. This paper outlines potential interdisciplinary approaches, such as bioinspired materials and nanotechnology applications, to address these challenges and pave the way for next-generation hemodialysis membranes that are safer, more effective, and more accessible.

Simulation-based assessment of zwitterionic pendant group variations on the hemocompatibility of polyethersulfone membranes

In the realm of hemodialysis, Polyethersulfone (PES) membranes dominate due to their exceptional stability and mechanical properties, capturing 93% of the market. Despite their widespread usage, the hydrophobic nature of PES introduces complications in hemodialysis, potentially leading to severe adverse reactions in patients with end-stage renal disease (ESRD) through protein fouling. Addressing this issue, our study focused on enhancing hemocompatibility by modifying PES surfaces with zwitterionic materials, known for their hydrophilicity and biological membrane compatibility. We investigated the functionalization of PES membranes utilizing various zwitterions in different ratios. Utilizing molecular docking, we examined the interactions of three zwitterionic ligands-carboxybetaine methacrylate (CBMA), sulfobetaine methacrylate (SBMA), and (2-(methacryloyloxy)ethyl) phosphorylcholine (MPC)-with human serum proteins. Our analysis revealed that a 1:1 ratio of phosphobetaine and sulfobetaine exhibits the lowest affinity energy towards serum proteins, denoting an optimal hemocompatibility without the limitations associated with increased zwitterion ratios. This pivotal finding offers a new pathway for developing more efficient and safer hemodialysis membranes, promising improved care for ESRD patients.

Supplementary information

The online version contains supplementary material available at 10.1186/s42252-024-00062-6.

Two-Dimensional Theoretical Analysis and Experimental Study of Mass Transfer in a Hollow-Fiber Dialysis Module Coupled with Ultrafiltration Operations

This research theoretically and experimentally develops a hollow-fiber dialysis module coupled with ultrafiltration operations by introducing a trans-membrane pressure during the membrane dialysis process, which can be applied to the waste metabolic end products in the human body for improving the dialysis efficiency. The solutes were transported by both diffusion and convection from the concentration driving-force gradient between retentate and dialysate phases across the membrane, compared to the traditional dialysis processes by diffusion only. A two-dimensional modeling of such a dialysis-and-ultrafiltration system in the hollow-fiber dialysis module was formulated and solved using the stream function coupled with the perturbation method to obtain the velocity distributions of retentate and dialysate phases, respectively. The purpose of the present work is to investigate the effect of ultrafiltration on the dialysis rate in the hollow-fiber dialyzer with ultrafiltration operations. A highest level of dialysis rate improvement up to about seven times (say 674.65% under Va=20 mL/min) was found in the module with ultrafiltration rate Vw=10 mL/min and membrane sieving coefficient θ=1, compared to that in the system without operating ultrafiltration. Considerable dialysis rate improvements on mass transfer were obtained by implementing a hollow-fiber dialysis-and-ultrafiltration system, instead of using the hollow-fiber dialyzer without ultrafiltration operation. The experimental runs were carried out under the same operating conditions for the hollow-fiber dialyzers of the two experimental runs with and without ultrafiltration operations for comparisons. A very reasonable prediction by the proposed mathematical model was observed.

Device Performance of a Tubular Membrane Dialyzer Incorporating Ultrafiltration Effects on the Dialysis Efficiency

Membrane dialysis is one of the membrane contactors applied to wastewater treatment. The dialysis rate of a traditional dialyzer module is restricted because the solutes transport through the membrane only by diffusion, in which the mass-transfer driving force across the membrane is the concentration gradient between the retentate and dialysate phases. A two-dimensional mathematical model of the concentric tubular dialysis-and-ultrafiltration module was developed theoretically in this study. The simulated results show that the dialysis rate improvement was significantly improved through implementing the ultrafiltration effect by introducing a trans-membrane pressure during the membrane dialysis process. The velocity profiles of the retentate and dialysate phases in the dialysis-and-ultrafiltration system were derived and expressed in terms of the stream function, which was solved numerically by the Crank-Nicolson method. A maximum dialysis rate improvement of up to twice that of the pure dialysis system (Vw=0) was obtained by employing a dialysis system with an ultrafiltration rate of Vw=2 mL/min and a constant membrane sieving coefficient of θ=1. The influences of the concentric tubular radius, ultrafiltration fluxes and membrane sieve factor on the outlet retentate concentration and mass transfer rate are also illustrated.

Preparation and surface modification of ultrahigh throughput tannic acid coblended polyethersulfone ultrafiltration membranes for hemodialysis

Low dialysis and blood incompatibility efficiency are key issues to be addressed for polymeric hemodialysis membranes. To improve the comprehensive performance of hemodialysis membranes, polyethersulfone (PES)/tannic acid (TA) coblended ultrafiltration membranes were prepared and modified with a heparin‐like functionalized TA coating. The coblended TA improved the pore structure of the PES ultrafiltration membrane. And it could also undergo π‐π conjugation with the heparin‐like functionalized TA in the modified solution, resulting in a greater abundance of modified groups loaded on the membrane surface and pores close to the surface. The modified coating further improved the membrane performance. The physicochemical properties, solute filtration, and blood compatibility properties of the membrane were tested. The effect of TA on the pore structure of the membrane and the presence of modified layers were demonstrated by morphological and chemical structure analyses. The final modified membrane had an ultrahigh water flux (1053 L/m2·h), improved dialysis performance (BSA retention >99%, Lysozyme clearance >30% and Urea clearance >90%), and excellent hemocompatibility (The hemolysis rate was 1.31%, and APTT, PT, and TT values were increased by 40.8%, 74.2%, and 85.9%, respectively). This study shows that TA has great potential for improving the pore structure of polymeric membranes.

A high-protein retained PES hemodialysis membrane with tannic acid as a multifunctional modifier

A high protein retention polyethersulfone (PES) membrane was prepared by nonsolvent-induced phase separation and surface coating, which exhibited enhanced hemocompatibility and antioxidant stress performance. The cross-linked network was constructed by tannic acid (TA) and alpha-lipoic acid (α-LA) on the surface of the membrane, which controlled the pores to a reasonable size. The enrichment of heparin-like groups on the membrane surface, implemented by "hydrophobic interaction" and "click reaction", confers anticoagulant properties; the presence of a large number of phenolic hydroxyl groups from TA and the introduction of α-LA allows the modified membranes to intervene in oxidative stress. The hemocompatibility characterizations included plasma recalcification time (PRT), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and hemolysis rate (HR). Additionally, the DPPH ABTS radical scavenging capacity was tested to evaluate the antioxidant performance. The results show that the modified membrane presents an outstanding protein retention rate (99.3%) along with permeability. In addition, the PRT is prolonged to 341.7 s, and the DPPH• scavenging ability reaches 0.74 µmol•cm-2. The membranes can be easily prepared and present excellent comprehensive performance. This work provides a simple and facile strategy for the fabrication of hemodialysis membranes with controllable pore sizes.

Impact of Membrane Modification and Surface Immobilization Techniques on the Hemocompatibility of Hemodialysis Membranes: A Critical Review

Despite significant research efforts, hemodialysis patients have poor survival rates and low quality of life. Ultrafiltration (UF) membranes are the core of hemodialysis treatment, acting as a barrier for metabolic waste removal and supplying vital nutrients. So, developing a durable and suitable membrane that may be employed for therapeutic purposes is crucial. Surface modificationis a useful solution to boostmembrane characteristics like roughness, charge neutrality, wettability, hemocompatibility, and functionality, which are important in dialysis efficiency. The modification techniques can be classified as follows: (i) physical modification techniques (thermal treatment, polishing and grinding, blending, and coating), (ii) chemical modification (chemical methods, ozone treatment, ultraviolet-induced grafting, plasma treatment, high energy radiation, and enzymatic treatment); and (iii) combination methods (physicochemical). Despite the fact that each strategy has its own set of benefits and drawbacks, all of these methods yielded noteworthy outcomes, even if quantifying the enhanced performance is difficult. A hemodialysis membrane with outstanding hydrophilicity and hemocompatibility can be achieved by employing the right surface modification and immobilization technique. Modified membranes pave the way for more advancement in hemodialysis membrane hemocompatibility. Therefore, this critical review focused on the impact of the modification method used on the hemocompatibility of dialysis membranes while covering some possible modifications and basic research beyond clinical applications.

Hemocompatibility challenge of membrane oxygenator for artificial lung technology

The artificial lung (AL) technology is one of the membrane-based artificial organs that partly augments lung functions, i.e. blood oxygenation and CO₂ removal. It is generally employed as an extracorporeal membrane oxygenation (ECMO) device to treat acute and chronic lung-failure patients, and the recent outbreak of the COVID-19 pandemic has re-emphasized the importance of this technology. The principal component in AL is the polymeric membrane oxygenator that facilitates the O₂/CO₂ exchange with the blood. Despite the considerable improvement in anti-thrombogenic biomaterials in other applications (e.g., stents), AL research has not advanced at the same rate. This is partly because AL research requires interdisciplinary knowledge in biomaterials and membrane technology. Some of the promising biomaterials with reasonable hemocompatibility - such as emerging fluoropolymers of extremely low surface energy - must first be fabricated into membranes to exhibit effective gas exchange performance. As AL membranes must also demonstrate high hemocompatibility in tandem, it is essential to test the membranes using in-vitro hemocompatibility experiments before in-vivo test. Hence, it is vital to have a reliable in-vitro experimental protocol that can be reasonably correlated with the in-vivo results. However, current in-vitro AL studies are unsystematic to allow a consistent comparison with in-vivo results. More specifically, current literature on AL biomaterial in-vitro hemocompatibility data are not quantitatively comparable due to the use of unstandardized and unreliable protocols. Such a wide gap has been the main bottleneck in the improvement of AL research, preventing promising biomaterials from reaching clinical trials. This review summarizes the current state-of-the-art and status of AL technology from membrane researcher perspectives. Particularly, most of the reported in-vitro experiments to assess AL membrane hemocompatibility are compiled and critically compared to suggest the most reliable method suitable for AL biomaterial research. Also, a brief review of current approaches to improve AL hemocompatibility is summarized. STATEMENT OF SIGNIFICANCE: The importance of Artificial Lung (AL) technology has been re-emphasized in the time of the COVID-19 pandemic. The utmost bottleneck in the current AL technology is the poor hemocompatibility of the polymer membrane used for O₂/CO₂ gas exchange, limiting its use in the long-term. Unfortunately, most of the in-vitro AL experiments are unsystematic, irreproducible, and unreliable. There are no standardized in-vitro hemocompatibility characterization protocols for quantitative comparison between AL biomaterials. In this review, we tackled this bottleneck by compiling the scattered in-vitro data and suggesting the most suitable experimental protocol to obtain reliable and comparable hemocompatibility results. To the best of our knowledge, this is the first review paper focusing on the hemocompatibility challenge of AL technology.

State-of-the-Art Organic- and Inorganic-Based Hollow Fiber Membranes in Liquid and Gas Applications: Looking Back and Beyond

The aggravation of environmental problems such as water scarcity and air pollution has called upon the need for a sustainable solution globally. Membrane technology, owing to its simplicity, sustainability, and cost-effectiveness, has emerged as one of the favorable technologies for water and air purification. Among all of the membrane configurations, hollow fiber membranes hold promise due to their outstanding packing density and ease of module assembly. Herein, this review systematically outlines the fundamentals of hollow fiber membranes, which comprise the structural analyses and phase inversion mechanism. Furthermore, illustrations of the latest advances in the fabrication of organic, inorganic, and composite hollow fiber membranes are presented. Key findings on the utilization of hollow fiber membranes in microfiltration (MF), nanofiltration (NF), reverse osmosis (RO), forward osmosis (FO), pervaporation, gas and vapor separation, membrane distillation, and membrane contactor are also reported. Moreover, the applications in nuclear waste treatment and biomedical fields such as hemodialysis and drug delivery are emphasized. Subsequently, the emerging R&D areas, precisely on green fabrication and modification techniques as well as sustainable materials for hollow fiber membranes, are highlighted. Last but not least, this review offers invigorating perspectives on the future directions for the design of next-generation hollow fiber membranes for various applications. As such, the comprehensive and critical insights gained in this review are anticipated to provide a new research doorway to stimulate the future development and optimization of hollow fiber membranes.

Hydrophilized Ultrafiltration Membranes Synthesized from Acrylic Acid Grafted Polyethersulfone for Downstream Processing of Therapeutic Insulin and Cobalamin

The present study focuses on synthesis of novel high-performance acrylic acid (AA) grafted polyethersulfone (PES) ultrafiltration (UF) membranes for purification of small therapeutic biomolecules such as urea, insulin, and cobalamin. The membranes were indigenously synthesized by adding polyethylene glycol (PEG) of 6 kDa M.Wt. as a pore former and subsequent grafting of AA using 2 to 6 wt.% concentrations under UV-induced photo grafting. Scanning electron microscopy reveals that the PEG additive profoundly influences the pore density on the membrane surface. FTIR spectra confirm the graft polymerization of AA with the PES substrate. Separation performance of the grafted membranes was evaluated to establish the trade-off between the degree of grafting and MWCO. From the experimental results, the pure water flux (PWF) of 6% grafted PES membrane was enhanced from 8.5 (PES [0] [6]) to 18.20 l m^-2 h^-1 (PES [6 +] [6]) in the presence of PEG pore former, respectively. The grafting concentration window of 2-6% resulted in selective membranes to altogether remove uremic toxins into the permeate with retention of high molecular size proteins. Hence, 5 and 6 wt.% AA grafted membranes exhibited > 90% rejection for insulin and cobalamin biomolecules along with 24.5 and 23.8 l m^-2 h^-1 bar^-1 permeability towards urea, respectively. The process results correlate well with the MWCO values of membranes ranging from 1 to 10 kDa. This work provides the efficacy of these grafted membranes for potential application in the downstream processing of therapeutic biomolecules such as insulin and cobalamin.

Fabrication of a Dual-Action Membrane with Both Antibacterial and Anticoagulant Properties via Cationic Polyelectrolyte-Induced Phase Separation

The development of microorganisms and formation of thrombus on a biomaterial surface can seriously lead to device failure and threaten human health. Nonetheless, a surface that has both antibacterial and anticoagulant properties has scarcely been developed. Herein, a novel dual-action membrane composed of polyethersulfone (PES) bulk material and a hydrophilic anionic poly-2-acrylamido-2-methylpropanesulfonic acid (PAMPS) polymer has been prepared via the cationic antibacterial agent poly(hexamethylene biguanide) (PHMB)-induced phase separation technique. Interestingly, the resultant membrane can offer tunable antibacterial and anticoagulant properties, while maintaining satisfactory permeability and greatly increasing selectivity. The membrane also shows excellent hydrophilicity, a well-defined porous surface, and cross section with a sponge gradient structure. Furthermore, the PHMB-PAMPS complex formed on the membrane surface displays outstanding long-term stability, which is crucial for further practical applications. More importantly, the hollow fiber membrane fabricated by the cationic polyelectrolyte-induced phase separation technique confirms its capability to control the membrane permeability (257.4 L·m^-2·h^-1·bar^-1) and selectivity (95.9%) without destroying the membrane structure. The present work opens a straightforward and efficient avenue for the rational design of a functional surface to fight biomedical material-associated infections.