TY - JOUR
T1 - In vitro thrombogenicity evaluation of rotary blood pumps by thromboelastometry
AU - Klein, Mario
AU - Tack, Jana Christine
AU - Mager, Ilona
AU - Maas, Judith
AU - Schmitz-Rode, Thomas
AU - Arens, Jutta
AU - Steinseifer, Ulrich
AU - Clauser, Johanna Charlotte
N1 - Funding Information:
Research funding: The authors acknowledge funding provided by the federal state of North Rhine-Westphalia and the European Regional Development Fund (ERDF), Grant number: EFRE-0800410, https://doi.org/10.13039/501100008530 . The funding organizations played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Publisher Copyright:
© 2022 Walter de Gruyter GmbH, Berlin/Boston 2022.
PY - 2022/11/28
Y1 - 2022/11/28
N2 - In vitro thrombogenicity tests for rotary blood pumps (RBPs) could benefit from assessing coagulation kinematics, as RBP design improves. In this feasibility study, we investigated if the method of thromboelastometry (TEM) is able to assess coagulation kinematics under the in vitro conditions of RBP tests. We conducted in vitro thrombogenicity tests (n=4) by placing Deltastream® DP3 pumps into test loops that were filled with 150 mL of slightly anti-coagulated porcine blood, adjusted to an activated clotting time (ACT) well below clinically recommended levels. Blood samples were taken at certain time points during the experiment until a continuous decrease in pump flow indicated major thrombus formation. Blood samples were analyzed for ACT, platelet count (PLT), and several TEM parameters. While visible thrombus formation was observed in three pumps, ACT indicated an ongoing activation of coagulation, PLT might have indicated platelet consumption. Unexpectedly, most TEM results gave no clear indications. Nonetheless, TEM clotting time obtained by non-anticoagulated and chemically non-activated whole blood (HEPNATEM-CT) appeared to be more sensitive for the activation of coagulation in vitro than ACT, which might be of interest for future pump tests. However, more research regarding standardization of thrombogenicity pump tests is urgently required.
AB - In vitro thrombogenicity tests for rotary blood pumps (RBPs) could benefit from assessing coagulation kinematics, as RBP design improves. In this feasibility study, we investigated if the method of thromboelastometry (TEM) is able to assess coagulation kinematics under the in vitro conditions of RBP tests. We conducted in vitro thrombogenicity tests (n=4) by placing Deltastream® DP3 pumps into test loops that were filled with 150 mL of slightly anti-coagulated porcine blood, adjusted to an activated clotting time (ACT) well below clinically recommended levels. Blood samples were taken at certain time points during the experiment until a continuous decrease in pump flow indicated major thrombus formation. Blood samples were analyzed for ACT, platelet count (PLT), and several TEM parameters. While visible thrombus formation was observed in three pumps, ACT indicated an ongoing activation of coagulation, PLT might have indicated platelet consumption. Unexpectedly, most TEM results gave no clear indications. Nonetheless, TEM clotting time obtained by non-anticoagulated and chemically non-activated whole blood (HEPNATEM-CT) appeared to be more sensitive for the activation of coagulation in vitro than ACT, which might be of interest for future pump tests. However, more research regarding standardization of thrombogenicity pump tests is urgently required.
KW - centrifugal blood pumps
KW - clot formation
KW - hemocompatibility
KW - mechanical circulatory support
KW - mock loop
KW - NLA
UR - http://www.scopus.com/inward/record.url?scp=85137710915&partnerID=8YFLogxK
U2 - 10.1515/bmt-2022-0078
DO - 10.1515/bmt-2022-0078
M3 - Article
C2 - 36041741
AN - SCOPUS:85137710915
SN - 0013-5585
VL - 67
SP - 471
EP - 480
JO - Biomedizinische Technik
JF - Biomedizinische Technik
IS - 6
ER -