Tuning Blood-Material Interactions to Generate Versatile Hemostatic Powders and Gels

Polymer-based hemostatic materials/devices have been increasingly exploited for versatile clinical scenarios, while there is an urgent need to reveal the rational design/facile approach for procoagulant surfaces through regulating blood-material interactions. In this work, degradable powders (PLPS) and thermoresponsive gels (F127-PLPS) are readily developed as promising hemostatic materials for versatile clinical applications, through tuning blood-material interactions with optimized grafting of cationic polylysine: the former is facilely prepared by conjugating polylysine onto porous starch particle, while F127-PLPS is prepared by the simple mixture of PLPS and commercial thermosensitive polymer. In vitro and in vivo results demonstrate that PLPS2 with the optimal-/medium content of polylysine grafts achieve the superior hemostatic performance. The underlying procoagulant mechanism of PLPS2 surface is revealed as the selective fibrinogen adsorption among the competitive plasma-protein-adsorption process, which is the foundation of other blood-material interactions. Moreover, in vitro results confirm the achieved procoagulant surface of F127-PLPS through optimal PLPS2 loading. Together with the tunable thermoresponsiveness, F127-PLPS exhibits outstanding hemostatic utilization in both femoral-artery-injury and renal-artery-embolization models. The work thereby pioneers an appealing approach for generating versatile polymer-based hemostatic materials/devices.

Control of Blood Coagulation by Hemocompatible Material Surfaces-A Review

Hemocompatibility of biomaterials in contact with the blood of patients is a prerequisite for the short- and long-term applications of medical devices such as cardiovascular stents, artificial heart valves, ventricular assist devices, catheters, blood linings and extracorporeal devices such as artificial kidneys (hemodialysis), extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass. Although lower blood compatibility of materials and devices can be handled with systemic anticoagulation, its side effects, such as an increased bleeding risk, make materials that have a better hemocompatibility highly desirable, particularly in long-term applications. This review provides a short overview on the basic mechanisms of blood coagulation including plasmatic coagulation and blood platelets, as well as the activation of the complement system. Furthermore, a survey on concepts for tailoring the blood response of biomaterials to improve the hemocompatibility of medical devices is given which covers different approaches that either inhibit interaction of material surfaces with blood components completely or control the response of the coagulation system, blood platelets and leukocytes.

Polyelectrolyte Multilayer Films Modification with Ag and rGO Influences Platelets Activation and Aggregate Formation under In Vitro Blood Flow

Surface functionalization of materials to improve their hemocompatibility is a challenging problem in the field of blood-contacting devices and implants. Polyelectrolyte multilayer films (PEMs), which can mimic functions and structure of an extracellular matrix (ECM), are a promising solution to the urgent need for functional blood-contacting coatings. The properties of PEMs can be easily tuned in order to provide a scaffold with desired physico-chemical parameters. In this study chitosan/chondroitin sulfate (Chi/CS) polyelectrolyte multilayers were deposited on medical polyurethane. Afterwards PEMs were modified by chemical cross-linking and nanoparticles introduction. Coatings with variable properties were tested for their hemocompatibility in the cone-plate tester under dynamic conditions. The obtained results enable the understanding of how substrate properties modulate PEMs interaction with blood plasma proteins and the morphotic elements.

The optimal incubation time for in vitro hemocompatibility testing: Assessment using polymer reference materials under pulsatile flow with physiological wall shear stress conditions

During hemocompatibility testing, activation products may reach plateau values which can result in less distinction between hemocompatible and hemo‐incompatible materials. Of concern is an underestimation of the blood activation caused by the biomaterial of interest, which may result in a false assessment of hemocompatibility. To elucidate the optimal incubation time for in vitro hemocompatibility testing, we used the Haemobile circulation model with human whole blood. Blood from healthy volunteers was in vitro incubated under pulsatile flow with physiological wall shear stress conditions at 37°C for 30, 60, 120, or 240 min. Test loops containing low‐density polyethylene and polydimethylsiloxane served as low and high reference materials, that is, hemocompatible and hemo‐incompatible biomaterials, respectively. In addition, empty loops served as a negative reference. Thrombogenicity, platelet function, inflammatory response, coagulation, and hemolysis between references and incubation times were compared. We found that thrombogenicity and platelet function were significantly affected by both the duration of incubation and the type of material. In particular, thrombogenicity and platelet function assessments were affected by incubation time. We found that an exposure time of 60 min was sufficient, and for almost all variables an optimal incubation time to discriminate between the low and high reference material. © 2019 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 2335–2342, 2019.

Fibrin clot extension on zirconia surface for dental implants: a quantitative in vitro study

PURPOSE

The surface chemical and physical properties of materials used for implants have a major influence on blood clot organization. This study aims to evaluate the blood clot extension (bce) on zirconia and titanium. bce was measured in association to surface roughness (Ra) and static contact angle (θ).

MATERIALS AND METHODS

Forty disk-shaped samples of sandblasted yttria tetragonal zirconia polycrystal (sb-YTZP), machined titanium (m-Ti), and sandblasted, high-temperature, acid-etched titanium (p-Ti) were used in the present study. About 0.2 mL of human blood, immediately dropped onto the specimen's surface and left in contact for 5 minutes at room temperature, was used to measure the bce. Specimens were observed under confocal scanning laser and scanning electron microscopes.

RESULTS

The bce (mean × 10(7)  ± standard deviation [SD] × 10(6)  μm(2) ) was 2.97 ± 6.68 for m-Ti, 5.64 ± 6.83 for p-Ti, and 3.61 ± 7.67 for sb-YTZP. p-Ti samples showed a significantly higher bce. Ra (mean ± SD [μm]) was 0.56 ± 0.7 for m-Ti, 3.78 ± 0.8 for p-Ti, and 2.68 ± 0.6 for sb-YTZP. The difference was not significant between sb-YTZP and p-Ti. θ (mean ± SD) was 55.6 ± 5.6 for m-Ti, 48.7 ± 2.8 for sb-YTZP, and 38.0 ± 2.2 for p-Ti. The difference was not significant between m-Ti and sb-YTZP.

CONCLUSIONS

The sb-YTZP demonstrated a significantly lesser amount of bce compared with p-Ti specimens, notwithstanding that any significant difference was present between Ra and θ.