Biocompatibility in hemapheresis: blood coagulation

Area of Science:

• Hematology
• Transfusion Medicine
• Coagulation Science

Background:

• Hemapheresis, a medical procedure, can impact the blood coagulation system.
• Coagulation changes involve both activation and dilution effects.
• These alterations are significant for donor safety and understanding hemapheresis physiology.

Purpose of the Study:

• To investigate the effects of hemapheresis on the coagulation system.
• To elucidate the mechanisms behind coagulation changes during apheresis.
• To characterize the impact on key coagulation factors and cellular components.

Main Methods:

• Review of hemapheresis procedures and their known physiological effects.
• Analysis of coagulation parameters including platelets, fibrinogen, and antithrombin III.
• Examination of the role of artificial surfaces in triggering coagulation activation.

Main Results:

• Hemapheresis causes both activation and dilution of coagulation factors.
• Dilution leads to decreased levels of platelets, fibrinogen, and antithrombin III.
• Initial hypercoagulability is followed by hypocoagulability due to factor consumption.
• Fibrinogen and antithrombin III depletion may be prolonged due to slower synthesis rates.
• Activation phenomena are common across various hemapheresis techniques, linked to fibrinogen layer formation on circuitry surfaces.

Conclusions:

• Hemapheresis induces transient but significant changes in the coagulation cascade.
• Understanding these effects is crucial for managing donor well-being.
• The interaction between blood components and artificial surfaces drives coagulation activation during apheresis.