The catastrophe revisited: blood compatibility in the 21st Century.
The biomaterials community has been unable to accurately assign the term "blood compatible" to a biomaterial in spite of 50 years of intensive research on the subject. There is no clear consensus as to which materials are "blood compatible." There are no standardized methods to assess blood compatibility. Since we use millions of devices in contact with blood each year, it is imperative we give serious thought to this intellectual catastrophe. In this perspective, I consider five hypotheses as to why progress has been slow in evolving a clear understanding of blood compatibility: Hypothesis 1-It is impossible to make a blood compatible material. Hypothesis 2-We do not understand the biology behind blood compatibility. Hypothesis 3-We do not understand how to test for or evaluate blood compatibility. Hypothesis 4-Certain materials of natural origin seem to show better blood compatibility but we do not know how to exploit this concept. Hypothesis 5-We now have better blood compatible materials but the regulatory and economic climate prevent adoption in clinical practice.
Ratner
Buddy D
BD
University of Washington Engineered Biomaterials (UWEB), University of Washington, Seattle, WA 98195, USA. ratner@uweb.engr.washington.edu
D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry*; D001698:Biomedical Engineering / Q000379:methods* / Q000639:trends*; D001769:Blood; D001777:Blood Coagulation; D001792:Blood Platelets / Q000378:metabolism; D004864:Equipment and Supplies / Q000592:standards; D017048:Health Care Costs; D006801:Humans; D008422:Materials Testing; D008967:Molecular Biology / Q000379:methods; D010973:Platelet Adhesiveness; D011108:Polymers / Q000737:chemistry; D012107:Research Design
D001672:Biocompatible Materials; D011108:Polymers
J Lab Clin Med. 1995 Feb;125(2):276-87
7531214
J Biomed Mater Res. 1994 Feb;28(2):225-32
8207035
Pharm Res. 1998 May;15(5):783-6
9619790
Biomaterials. 1998 Dec;19(23):2129-38
9884053
J Biomed Mater Res A. 2005 Jul 1;74(1):69-83
15909286
J Biomed Mater Res A. 2005 Sep 15;74(4):722-38
16037938
J Biomed Mater Res A. 2005 Oct 1;75(1):199-209
16082704
Biomaterials. 2007 Mar;28(8):1523-30
17157376
J Biomed Mater Res A. 2007 Jun 15;81(4):827-37
17236214
J Biomater Sci Polym Ed. 2000;11(11):1239-59
11263811
J Biomed Mater Res. 2002 Jun 5;60(3):348-59
11920657
J Am Chem Soc. 2003 Aug 13;125(32):9552-3
12903997
Colloids Surf B Biointerfaces. 2004 Jul 1;36(1):27-33
15261020
Thromb Diath Haemorrh. 1974 May 15;31(2):188-203
4850635
Trans Am Soc Artif Intern Organs. 1972;18(0):10-18
4679861
J Lab Clin Med. 1980 Feb;95(2):289-304
6766491
J Biomed Mater Res. 1993 Mar;27(3):283-7
8360198
J Biomater Sci Polym Ed. 1993;4(5):451-65
8241062
Biomaterials. 1997 Dec;18(23):1511-22
9430333