Blood-Contacting Surfaces - Biomaterials Fabrication and Processing - page 505

17

Blood-Contacting Surfaces

Menno L.W. Knetsch

CONTENTS

17.1 Introduction.......................................................................................................................... 505
17.2 Blood.................................................................................................................................... 506
17.2.1 Erythrocytes ............................................................................................................ 507
17.2.2 Leukocytes............................................................................................................... 507
17.2.3 Platelets.................................................................................................................... 508
17.2.4 Plasma...................................................................................................................... 508
17.3 Blood Vessels ....................................................................................................................... 508
17.4 Blood-Contacting Devices ................................................................................................... 509
17.5 Interaction of Blood with Synthetic Surfaces ...................................................................... 510
17.5.1 Protein Adsorption .................................................................................................. 510
17.5.2 Coagulation.............................................................................................................. 510
17.5.2.1 Common Pathway .................................................................................... 510
17.5.2.2 Intrinsic Pathway...................................................................................... 513
17.5.2.3 Extrinsic Pathway..................................................................................... 513
17.5.3 Platelet Adhesion and Activation ............................................................................ 515
17.5.4 Complement System ................................................................................................ 516
17.5.5 Leukocytes............................................................................................................... 517
17.6 Surfaces of Blood-Contacting Devices................................................................................ 517
17.6.1 Bioinert Materials in Blood-Contacting Devices .................................................... 518
17.6.2 Polymeric Coatings.................................................................................................. 519
17.6.3 Living Cell Layer as Boundary Layer ..................................................................... 521
17.6.4 Tissue Engineering .................................................................................................. 522
17.7 Blood Compatibility Testing................................................................................................ 523
17.7.1 Thrombin Generation and Thrombus Formation .................................................... 524
17.7.2 Platelet Adhesion and Activation ............................................................................ 526
17.7.2.1 Determination of Platelet Adhesion ......................................................... 526
17.7.2.2 Platelet Activation .................................................................................... 527
17.7.2.3 Secretion by Activated Platelets............................................................... 528
17.7.3 Leukocyte Adhesion and Activation ....................................................................... 528
17.7.4 Complement Activation ........................................................................................... 529
17.7.5 Hemolysis ................................................................................................................ 529
17.7.6 Cell Compatibility/Endothelialization .................................................................... 529
17.8 Concluding Remarks............................................................................................................ 530
References ...................................................................................................................................... 531

17.1 INTRODUCTION
Upon implantation of a medical device, blood is the fi rst tissue that comes into contact with the
implant. This is caused by damage of tissue and blood vessels during the implantation procedure.

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