Formation of thrombin-antithrombin III complex using polyamide and hemophan dialyzers.
The recently developed ELISA for the thrombin-antithrombin III complex (TAT) is a sensitive, specific, and simplified means of detecting intravascular coagulation. For further evaluation of the thrombogenicity of a polyamide (P) and a Hemophan (H) hollow-fibre dialyzer a cross-over study was done in ten stable patients on maintenance hemodialysis. At the same doses of heparin (mean bolus of 30 U/kg bw and maintenance doses of 86 U/kg bw), thrombin time and partial thromboplastin time were significantly lower using H. At the end of dialysis TAT was significantly higher in H (mean +/- SEM before HD 3.57 +/- .56, at 240 min 14.9 +/- 6.5 ng/ml, p less than 0.05, Wilcoxon-test) than in P (before HD 4.36 +/- .98, at 240 min 8.95 +/- 3.0 ng/ml, p less than 0.05 H 240 vs. P 240, Wilcoxon-test). Visible clotting was more pronounced in the H filter. Among other favourable features of blood compatibility the polyamide/polyvinylpyrrolidone copolymer with a hydrophilic/hydrophobic microdomain structure has less thrombogenicity. The modified cellulosic membrane H has advantages in complement activation and leukocyte depression, but thrombogenicity seems less favourable since the incorporated diethyl-amino-ethyl groups with their positive charge bind and inactivate negatively charged heparin.
Schultze
G
G
Humboldt-Krankenhaus, Berlin, Germany.
Hollmann
S
S
Sinah
P
P
D000990:Antithrombin III / Q000032:analysis*; D001777:Blood Coagulation; D002482:Cellulose / Q000031:analogs & derivatives*; D006801:Humans; D007958:Leukocyte Count; D008567:Membranes, Artificial; D009757:Nylons; D010447:Peptide Hydrolases / Q000032:analysis*; D010976:Platelet Count; D006435:Renal Dialysis
D008567:Membranes, Artificial; D009757:Nylons; C046193:antithrombin III-protease complex; C054645:Hemophan; D000990:Antithrombin III; D002482:Cellulose; D010447:Peptide Hydrolases