Preparation and thrombogenicity of alkylated polyvinyl alcohol coated tubing

A polyvinyl alcohol hydrogel (PVA) was reacted with a C18 isocyanate at 80 degrees C in dimethyl formamide (DMF) in order to improve the platelet reactivity of the hydrogel through an influence on albumin adsorption or retention. A C4 isocyanate was used as a control. Surface coverage by XPS appeared to be approximately 100% for both C4 and C18 modified surfaces, although the limited solubility of C18 isocyanate in DMF may have resulted in a nonuniform surface. Relative to PVA or the solvent treated control, octadecylation resulted in increased albumin adsorption (from a single protein solution) and increased retention when the adsorbed albumin was exposed to a fibrinogen solution. However, octadecylation did not obviate the platelet reactivity problem in preliminary studies: systemic platelet counts were reduced by about half over 4 days in a canine AV shunt experiment and the initial rate of platelet destruction for C18-PVA was greater (36%/day) even than for the solvent-treated PVA. Surprisingly in preliminary studies butylation of PVA resulted in little or no thrombocytopenia and did not appear to increase significantly the fractional rate of platelet destruction relative to the shunt only blank. It is presumed that the nonspecific effect of alkylation (independent of chain length) was the dominant contribution to the reduced platelet reactivity. A similar effect of C18-PVA presumably would have been observed had the limited solubility of C18 isocyanate not precluded a uniform surface coverage.