Kuchinka Janna, Willems Christian, Telyshev Dmitry V, Groth Thomas
Department Biomedical Materials, Institute of Pharmacy, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany.
Institute of Biomedical Systems, National Research University of Electronic Technology, Zelenograd, 124498 Moscow, Russia.
Bioengineering (Basel). 2021 Dec 15;8(12):215. doi: 10.3390/bioengineering8120215.
Hemocompatibility of biomaterials in contact with the blood of patients is a prerequisite for the short- and long-term applications of medical devices such as cardiovascular stents, artificial heart valves, ventricular assist devices, catheters, blood linings and extracorporeal devices such as artificial kidneys (hemodialysis), extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass. Although lower blood compatibility of materials and devices can be handled with systemic anticoagulation, its side effects, such as an increased bleeding risk, make materials that have a better hemocompatibility highly desirable, particularly in long-term applications. This review provides a short overview on the basic mechanisms of blood coagulation including plasmatic coagulation and blood platelets, as well as the activation of the complement system. Furthermore, a survey on concepts for tailoring the blood response of biomaterials to improve the hemocompatibility of medical devices is given which covers different approaches that either inhibit interaction of material surfaces with blood components completely or control the response of the coagulation system, blood platelets and leukocytes.
生物材料与患者血液接触时的血液相容性是心血管支架、人工心脏瓣膜、心室辅助装置、导管、血液内衬以及人工肾（血液透析）、体外膜肺氧合（ECMO）和体外循环等体外装置等医疗器械短期和长期应用的先决条件。尽管材料和装置较低的血液相容性可以通过全身抗凝来处理，但其副作用，如出血风险增加，使得具有更好血液相容性的材料非常受欢迎，尤其是在长期应用中。本综述简要概述了包括血浆凝血和血小板在内的血液凝固基本机制，以及补体系统的激活。此外，还对调整生物材料血液反应以改善医疗器械血液相容性的概念进行了调查，涵盖了完全抑制材料表面与血液成分相互作用或控制凝血系统、血小板和白细胞反应的不同方法。
