Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Freiburg, Germany.
Tokyo Medical and Dental University, Tokyo, Japan.
Sci Rep. 2020 Dec 16;10(1):22055. doi: 10.1038/s41598-020-78709-0.
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.
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。