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Formation of thrombin-antithrombin III complex using polyamide and hemophan dialyzers
G Schultze1, S Hollmann, P Sinah
1Humboldt-Krankenhaus, Berlin, Germany.
The International Journal of Artificial Organs
|June 1, 1992
Summary
The Hemophan dialyzer showed increased thrombogenicity compared to polyamide, indicated by higher thrombin-antithrombin III complex levels. This suggests polyamide is more blood-compatible for hemodialysis patients.
Area of Science:
- Nephrology
- Biomaterials Science
- Hematology
Background:
- Intravascular coagulation detection is crucial in hemodialysis.
- Evaluating dialyzer thrombogenicity is essential for patient safety.
- Thrombin-antithrombin III complex (TAT) ELISA is a key diagnostic tool.
Purpose of the Study:
- To compare the thrombogenicity of polyamide (P) and Hemophan (H) hollow-fibre dialyzers.
- To assess blood compatibility during maintenance hemodialysis.
- To evaluate the impact of dialyzer membranes on coagulation parameters.
Main Methods:
- Cross-over study in ten stable hemodialysis patients.
- Measurement of thrombin time, partial thromboplastin time, and TAT complex levels.
- Standardized heparin dosage for both dialyzer types.
Main Results:
- Hemophan (H) showed significantly lower thrombin time and partial thromboplastin time.
- TAT levels were significantly higher at the end of dialysis with Hemophan (H) compared to Polyamide (P).
- Visible clotting was more pronounced in the Hemophan (H) filter.
Conclusions:
- Polyamide (P) exhibits lower thrombogenicity than Hemophan (H) in hemodialysis.
- Hemophan's (H) positively charged groups may negatively impact heparin efficacy, increasing thrombogenicity.
- Polyamide/polyvinylpyrrolidone copolymer demonstrates favorable blood compatibility with reduced thrombogenicity.