Cell adhesion and tissue factor upregulation in oxygenators used during coronary artery bypass grafting are modified by the Corline Heparin Surface.
OBJECTIVE
Cardiopulmonary bypass (CPB) is associated with inflammatory response and activation of coagulation. We investigated the influence of a new heparin surface on the activation of cells retrieved from oxygenators used during coronary artery bypass grafting (CABG).


METHODS
Sixty patients undergoing CABG with CPB were randomly assigned to either uncoated or completely Corline Heparin Surface (CHS)-coated circuits with one of three different levels of systemic heparin: standard, high or low. At end of surgery adhered cells were retrieved from the oxygenators and cell count, tissue factor (TF)- and CD11b-expression on monocytes and monocytic TFmRNA were analysed.


RESULTS
The heparin coating of the oxygenator prevented adhesion of granulocytes, monocytes and platelets. TF-expression on monocytes from the oxygenators was significantly higher than on circulating cells in all groups. Monocytes from the uncoated oxygenators showed low levels of TF-expression with high levels of TFmRNA. The coated group with high level of heparin showed higher surface-expression of TF with low levels of TFmRNA.


CONCLUSIONS
The CHS was most biocompatible with the standard level of heparin used during CABG whereas elevation of systemic heparin rather increased the activation and TF upregulation in monocytes from oxygenators.
Johnell
M
M
Laboratory for Coagulation Research, Department of Medical Sciences, Clinical Chemistry, University Hospital, SE-751 85 Uppsala, Sweden.
Elgue
G
G
Thelin
S
S
Larsson
R
R
Siegbahn
A
A
D000368:Aged; D000704:Analysis of Variance; D000925:Anticoagulants / Q000494:pharmacology*; D039481:CD11b Antigen / Q000187:drug effects; D002315:Cardiopulmonary Bypass; D002448:Cell Adhesion / Q000187:drug effects*; D003196:Computer Graphics; D001026:Coronary Artery Bypass; D005260:Female; D006493:Heparin / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010107:Oxygenators, Membrane; D018709:Statistics, Nonparametric; D013925:Thromboplastin / Q000187:drug effects*; D015854:Up-Regulation
D000925:Anticoagulants; D039481:CD11b Antigen; D006493:Heparin; D013925:Thromboplastin