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新型磁悬浮离心式血泵技术与 CentriMag 成人血泵的血液相容性比较。

Hemocompatibility of new magnetically-levitated centrifugal pump technology compared to the CentriMag adult pump.

机构信息

Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Freiburg, Germany.

Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Sci Rep. 2020 Dec 16;10(1):22055. doi: 10.1038/s41598-020-78709-0.

Abstract

The specific hemocompatibility properties of mechanical-circulatory-support (MCS)-pump technologies have not previously been described in a comparable manner. We thus investigated the hemocompatibility-indicating marker of a new magnetically-levitated (MagLev) centrifugal pump (MT-Mag) in a human, whole-blood mock-loop for 360 min using the MCS devices as a driving component. We compared those results with the CentriMag adult (C-Mag) device under the same conditions according to ISO10993-4. Blood samples were analyzed via enzyme-linked-immunosorbent-assay (ELISA) for markers of coagulation, complement system, and the inflammatory response. The time-dependent activation of the coagulation system was measured by detecting thrombin-anti-thrombin complexes (TAT). The activation of the complement system was determined by increased SC5b-9 levels in both groups. A significant activation of neutrophils (PMN-elastase) was detected within the C-Mag group, but not in the MT-Mag group. However, the amount of PMN-elastase at 360 min did not differ significantly between groups. The activation of the complement and coagulation system was found to be significantly time-dependent in both devices. However, coagulation activation as determined by the TAT level was lower in the MT-Mag group than in the C-Mag group. This slight disparity could have been achieved by the optimized secondary flow paths and surface coating, which reduces the interaction of the surface with blood.

摘要

机械循环支持 (MCS) - 泵技术的特定血液相容性特性以前没有以可比的方式描述过。因此,我们使用 MCS 设备作为驱动组件,在人体全血模拟回路中使用新型磁悬浮 (MagLev) 离心泵 (MT-Mag) 进行了 360 分钟的血液相容性指示标志物研究。我们根据 ISO10993-4 ,将这些结果与相同条件下的 CentriMag 成人 (C-Mag) 设备进行了比较。通过酶联免疫吸附测定 (ELISA) 分析血液样本,以检测凝血、补体系统和炎症反应的标志物。通过检测凝血酶-抗凝血酶复合物 (TAT) 来测量凝血系统的时间依赖性激活。两组的 SC5b-9 水平均升高,表明补体系统被激活。在 C-Mag 组中检测到中性粒细胞 (PMN-弹性蛋白酶) 的显著激活,但在 MT-Mag 组中未检测到。然而,两组在 360 分钟时的 PMN-弹性蛋白酶量没有显著差异。在两种设备中,均发现补体系统和凝血系统的激活具有明显的时间依赖性。然而,MT-Mag 组的 TAT 水平较低,表明凝血激活程度较低。这种微小差异可能是通过优化的二次流路和表面涂层实现的,这减少了表面与血液的相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3734/7744571/48750124bc1c/41598_2020_78709_Fig1_HTML.jpg

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