title: Assessment of the heparin-binding AN69 ST hemodialysis membrane: II. Clinical studies without heparin administration.
abstract: Binding polyanionic unfractionated heparin over the modified AN69 polyacrylonitrile membrane, the surface electronegativity of which has been neutralized by polyethyleneimine (AN69-ST), renders the membrane more hemocompatible. This property was tested in two groups of long-term hemodialysis patients. Results were rated as massive or partial clotting of a dialyzer at the end of the session. Group I patients were included in a prospective, cross-over study comparing standard dialysis with hemodialysis without systemic administration of unfractionated heparin (n = 12, 123 sessions). In all instances, priming was made with 2 I saline containing 5,000 IU/l heparin. Only patchy or partial clotting was observed in 11% and 39% of the sessions with standard and heparin-free administration, respectively. Group II patients were included in an open, observational pilot study testing the effects of the heparin-coated membrane, without systemic administration of heparin, in patients at high risk of bleeding (n = 68, 331 sessions). Massive clotting was observed in six sessions only (less than 2%) and normal or slightly patchy dialyzers were found in 88% of the sessions. It is concluded that the dialysis AN69 ST membrane, after adequate priming at bedside, can be used without systemic administration of heparin for hemodialysis in patients at high risk of bleeding.
authors.affiliation: Service de Néphrologie, Centre Hospitalier et Universitaire and CNRS FRE 2534, Reims, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lavaud
authors.forename: Bruno
authors.initials: B
authors.lastname: Paris
authors.forename: Herve
authors.initials: H
authors.lastname: Maheut
authors.forename: Christine
authors.initials: C
authors.lastname: Randoux
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Renaux
authors.forename: Philippe
authors.initials: P
authors.lastname: Rieu
authors.forename: Jacques
authors.initials: J
authors.lastname: Chanard
mesh_terms: D000180:Acrylic Resins; D000925:Anticoagulants / Q000378:metabolism*; D001672:Biocompatible Materials; D001777:Blood Coagulation; D018592:Cross-Over Studies; D004797:Enzyme-Linked Immunosorbent Assay; D015951:Factor Xa / Q000378:metabolism; D065427:Factor Xa Inhibitors; D006493:Heparin / Q000378:metabolism*; D006801:Humans; D008567:Membranes, Artificial; D010314:Partial Thromboplastin Time; D010865:Pilot Projects; D011094:Polyethyleneimine; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods; D013917:Thrombin / Q000096:biosynthesis; D013997:Time Factors
chemical_list: D000180:Acrylic Resins; D000925:Anticoagulants; D001672:Biocompatible Materials; D065427:Factor Xa Inhibitors; D008567:Membranes, Artificial; C010504:polyacrylonitrile; D011094:Polyethyleneimine; D006493:Heparin; D013917:Thrombin; D015951:Factor Xa