From the Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration (FDA), Silver Spring, Maryland.
ASAIO J. 2023 Jun 1;69(6):576-582. doi: 10.1097/MAT.0000000000001897. Epub 2023 Feb 27.
To develop and standardize a reliable in vitro dynamic thrombogenicity test protocol, the key test parameters that could impact thrombus formation need to be investigated and understood. In this study, we evaluated the effect of temperature on the thrombogenic responses (thrombus surface coverage, thrombus weight, and platelet count reduction) of various materials using an in vitro blood flow loop test system. Whole blood from live sheep and cow donors was used to assess four materials with varying thrombogenic potentials: negative-control polytetrafluoroethylene (PTFE), positive-control latex, silicone, and high-density polyethylene (HDPE). Blood, heparinized to a donor-specific concentration, was recirculated through a polyvinyl chloride tubing loop containing the test material at room temperature (22-24°C) for 1 hour, or at 37°C for 1 or 2 hours. The flow loop system could effectively differentiate a thrombogenic material (latex) from the other materials for both test temperatures and blood species ( p < 0.05). However, compared with 37°C, testing at room temperature appeared to have slightly better sensitivity in differentiating silicone (intermediate thrombogenic potential) from the relatively thromboresistant materials (PTFE and HDPE, p < 0.05). These data suggest that testing at room temperature may be a viable option for dynamic thrombogenicity assessment of biomaterials and medical devices.
为了开发和标准化可靠的体外动态血栓形成性测试方案,需要研究和了解可能影响血栓形成的关键测试参数。在这项研究中,我们使用体外血流回路测试系统评估了温度对各种材料的血栓形成反应(血栓表面覆盖率、血栓重量和血小板计数减少)的影响。使用来自活绵羊和牛供体的全血来评估具有不同血栓形成潜力的四种材料:阴性对照聚四氟乙烯(PTFE)、阳性对照乳胶、硅酮和高密度聚乙烯(HDPE)。肝素化至供体特异性浓度的血液在室温(22-24°C)下在含有测试材料的聚氯乙烯管回路中循环 1 小时,或在 37°C 下循环 1 或 2 小时。该流路系统能够有效地将一种血栓形成材料(乳胶)与其他两种材料(测试温度和血液种类)区分开来(p<0.05)。然而,与 37°C 相比,在室温下进行测试似乎在区分具有中等血栓形成潜力的硅酮与相对抗血栓形成的材料(PTFE 和 HDPE)方面具有稍高的灵敏度(p<0.05)。这些数据表明,在室温下进行测试可能是生物材料和医疗器械动态血栓形成评估的可行选择。