Reactions of blood with nonbiologic surfaces. Ultrastructural and clotting studies with normal and coagulation factor deficient bloods.

Interaction of normal and coagulation factor deficient bloods with glass, Teflon and silicone-coated glass surfaces have been studied. The morphology of the blood-surface interaction was observed by scanning electron microscopy. Activation of the intrinsic coagulation system and progression of these changes, monitored by use of the partial thromboplastin time test, were influenced by both the type of surface to which blood was exposed and the deficiencies of coagulation Factors I, VIII, IX, or XII. Deficiency of fibrinogen appears to enhance, minimally, activation of the coagulation sequences by test materials. However, deficiency of fibrinogen markedly reduces adhesion of platelets to foreign surfaces. Deficiency of Factor XII, but not of Factors VIII or IX, decreases platelet adhesion to nonbiologic surfaces but to a lesser extent than does deficiency of fibrinogen. Roughness of test surfaces appears to encourage cellular deposition from blood. An ex vivo model designed for screening materials for their compatibility with blood is described.