title: Microfluidic approaches for the assessment of blood cell trauma: a focus on thrombotic risk in mechanical circulatory support devices.
abstract: BACKGROUND
  Mechanical circulatory support devices (MCSDs) are emerging as a valuable therapeutic option for the management of end-stage heart failure. However, although recipients are routinely administered with anti-thrombotic (AT) drugs, thrombosis persists as a severe post-implant complication. Conventional clinical assays and coagulation markers demonstrate partial ability in preventing the onset of thrombosis. Through years, different laboratory techniques have been proposed as potential tools for the evaluation of platelets' hemostatic response in MCSD recipients. Most rely on platelet aggregation tests; they are performed in static or low shear conditions, neglecting the prominent contribution of MCSD shear-induced mechanical load in enhancing platelet activation (PA). On the other hand, those tests able to account for shear-induced PA have limited possibility of effective clinical translation.
  
  
  OBJECTIVE
  Advances on this side have been addressed by microfluidic technology. Microfluidic devices have been developed for AT drug monitoring under flow, able to replicate physiological and/or constant shear flow conditions in vitro. In this paper, we present a newly developed microfluidic platform able to expose platelets to MCSD-specific dynamic shear stress patterns. We performed in vitro tests circulating human platelets in the microfluidic platform and quantifying the dynamics of PA by means of the Platelet Activity State (PAS) assay.
  
  
  RESULTS
  Our results prove the feasibility of using microfluidics for the diagnosis of MCSD-related thrombotic risk. This study paves the way for the development of a miniaturized point-of-care device for monitoring AT drug regimen. Such a system may have significant impact on limiting the incidence of thrombosis in MCSD recipients.
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano - Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Consolo
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano - Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Dimasi
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano - Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Rasponi
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano - Italy.|Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milano - Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Valerio
authors.affiliation: Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milano - Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Pappalardo
authors.affiliation: Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York - USA.
authors.forename: Danny
authors.initials: D
authors.lastname: Bluestein
authors.affiliation: Department of Medicine and Biomedical Engineering, The University of Arizona, Tucson, Arizona - USA.
authors.forename: Marvin J
authors.initials: MJ
authors.lastname: Slepian
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano - Italy.
authors.forename: Gianfranco Beniamino
authors.initials: GB
authors.lastname: Fiore
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano - Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Redaelli
mesh_terms: D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D001792:Blood Platelets / Q000187:drug effects; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006487:Hemostasis; D006801:Humans; D044085:Microfluidics; D015539:Platelet Activation / Q000502:physiology*; D019095:Point-of-Care Systems; D013314:Stress, Mechanical; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control