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Updated: Jan 28, 2026

In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Device-induced platelet dysfunction in mechanically assisted circulation increases the risks of thrombosis and
Zengsheng Chen1, Jiafeng Zhang1, Kafayat Kareem1
1Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Mechanical circulatory support (MCS) devices like the CentriMag pump activate platelets, increasing their adhesion to fibrinogen but reducing their interaction with collagen and VWF. This dual effect on platelet function and von Willebrand factor (VWF) may explain simultaneous thrombosis and bleeding risks in patients.
Area of Science:
- Biomedical Engineering
- Hematology
- Cardiovascular Research
Background:
- Mechanical circulatory support (MCS) devices are crucial for patients with heart failure.
- Thrombotic and bleeding complications remain significant challenges limiting MCS device use.
- Blood-device interactions, particularly platelet damage, are key factors in these complications.
Purpose of the Study:
- To investigate how a clinical rotary blood pump (CentriMag) affects platelet receptors and von Willebrand factor (VWF).
- To understand the impact of device-induced changes on platelet function and hemostasis.
- To correlate these changes with thrombosis and bleeding risks in MCS patients.
Main Methods:
- Human whole blood circulated through a CentriMag pump for 4 hours.
- Flow cytometry used to assess platelet glycoprotein (GP) IIb/IIIa activation and GPVI/GPIbα receptor loss.
- ELISA measured soluble P-selectin for platelet activation.
- Fluorescent microscopy quantified platelet adhesion to fibrinogen, collagen, and VWF.
- Western blotting analyzed VWF damage, focusing on high molecular weight multimers (HMWM).
Main Results:
- The CentriMag pump induced progressive platelet activation (GPIIb/IIIa, soluble P-selectin) and receptor loss (GPVI, GPIbα) over 4 hours.
- Activated platelets showed increased adhesion to fibrinogen but reduced adhesion to collagen and VWF.
- High molecular weight multimers (HMWM) of VWF disappeared within the first hour, with stable multimeric patterns thereafter.
- VWF changes differed from progressive platelet alterations.
Conclusions:
- The CentriMag blood pump causes complex, opposing effects on platelet function and VWF.
- Device-induced platelet activation and VWF degradation may contribute to both thrombosis and bleeding.
- Platelet damage is a likely cause of bleeding in patients using rotary blood pump MCS systems.
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