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Abstract: TH-PO0449

Evaluation of In Vitro Thrombogenicity Among Different Dialyzer Membranes

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Nitschel, Robert, Fresenius Medical Care Deutschland GmbH, Sankt Wendel, Germany
  • Zawada, Adam M., Fresenius Medical Care Deutschland GmbH, Sankt Wendel, Germany
  • Griesshaber, Bettina, Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany
  • Stauss-Grabo, Manuela, Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany
  • Kamerath, Craig D, Fresenius Medical Care North America, Ogden, Utah, United States
  • Crook, Nathan S, Fresenius Medical Care North America, Ogden, Utah, United States
  • Boyington, Skyler, Fresenius Medical Care North America, Ogden, Utah, United States
  • Kennedy, James Paul, Fresenius Medical Care North America, Ogden, Utah, United States
  • Erlenkoetter, Ansgar, Fresenius Medical Care Deutschland GmbH, Sankt Wendel, Germany
Background

Dialyzer membranes exert thrombogenic potential which contributes to clotting risk during dialysis treatments, necessitating systemic anticoagulation. The two major components involved in this process are plasmatic coagulation and platelet activation. Hydrophilic modification of dialysis membranes improve the hemocompatibility profile, as previously shown for the novel FX CorAL dialyzer with increased polyvinylpyrrolidone (PVP) content on the blood-side surface. In the present study we investigated if the hydrophilic modification of the FX CorAL dialyzer has a positive impact on in-vitro thrombogenicity as compared to other synthetic dialyzer membranes.

Methods

In a recirculation setup with human blood, platelet activation (platelet counts, β-thromboglobulin [β-TG]) as well as plasmatic coagulation (thrombin–antithrombin complex [TAT]) were investigated among polysulfone-based (FX CorAL, FX CorDiax, Optiflux [all Fresenius Medical Care], xevonta [B.Braun]) and polyethersulfone-based dialyzers (ELISIO [Nipro], Revaclear, Theranova [both Baxter]). Additionally, fluorescence microscopy was used to visualize platelet adsorption to the different dialyzer membranes. For this purpose, the membranes were cut open and stained with a CD41a-FITC.

Results

FX CorAL showed significantly lower platelet count reduction (FX CorDiax: 3.8 fold, p<0.001; Optiflux: 4.7 fold, p<0.001; xevonta: 4.3 fold, p<0.001; ELISIO: 3.5 fold, p<0.001; Revaclear: 2.8 fold, p=0.003; Theranova: 4.2 fold, p<0.001) and lower β-TG levels (FX CorDiax: 5.9 fold, p=0.006; Optiflux: 5.8 fold, p=0.005; xevonta; 4.8 fold, p=0.021; ELISIO: 4.6 fold, p=0.020; Revaclear: 2.9 fold, p=0.051; Theranova: 6.3 fold, p=0.045) than all other investigated dialyzers. These results correlated with the fluorescence microscopy images, with lowest platelet adsorption to the FX CorAL membrane. Regarding plasmatic coagulation, no significant differences were observed between the investigated dialyzers.

Conclusion

The present in-vitro study supports previous findings that increased membrane hydrophilicity reduces platelet activation. As no differences were observed for plasmatic coagulation, further experimental and clinical studies are needed to evaluate the impact of hydrophilic modification on clotting risk.

Funding

  • Commercial Support – Fresenius Medical Care Deutschland GmbH

Digital Object Identifier (DOI)