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Cell adhesion and tissue factor upregulation in oxygenators used during coronary artery bypass grafting are modified

M Johnell1, G Elgue, S Thelin

  • 1Laboratory for Coagulation Research, Department of Medical Sciences, Clinical Chemistry, University Hospital, SE-751 85 Uppsala, Sweden.

Scandinavian Cardiovascular Journal : SCJ
|March 11, 2003
PubMed

Insights

A new heparin surface coating on cardiopulmonary bypass circuits reduces cell adhesion during coronary artery bypass grafting (CABG). Standard heparin levels with this coating are most biocompatible, preventing monocyte activation.

Area of Science:

  • Biomedical Engineering
  • Cardiovascular Surgery
  • Hematology

Background:

  • Cardiopulmonary bypass (CPB) can trigger inflammatory responses and coagulation activation.
  • Cellular activation within oxygenators during CPB is a concern in coronary artery bypass grafting (CABG).

Purpose of the Study:

  • To evaluate the impact of a novel heparin surface coating on oxygenator circuits.
  • To assess cellular activation, specifically monocytes, within oxygenators during CABG.

Main Methods:

  • Sixty patients undergoing CABG with CPB were randomized to uncoated or Corline Heparin Surface (CHS)-coated circuits.
  • Three systemic heparin levels (standard, high, low) were tested.
  • Adhered cells from oxygenators were analyzed for cell count, tissue factor (TF), and CD11b expression, and monocytic TF mRNA.

Main Results:

  • The CHS coating effectively prevented granulocyte, monocyte, and platelet adhesion.
  • Monocytes from oxygenators showed higher TF expression compared to circulating cells.
  • Uncoated oxygenators had low TF expression but high TF mRNA; CHS with high heparin showed high TF expression and low TF mRNA.

Conclusions:

  • The CHS coating demonstrated superior biocompatibility with standard heparin levels during CABG.
  • Elevated systemic heparin levels, in conjunction with the CHS coating, paradoxically increased monocyte activation and TF upregulation.
Abstract

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