COMPARISON OF THE INFLUENCE OF VARIOUS SYNTHETIC DIALYSIS MEMBRANE ON PLATELET ACTIVATION AND GPIIb/IIIa

Abstract

Purpose: Biocompatibility of dialysis membrane is defined, in part, by tendency to activate the coagulation. Glycoprotein IIb/IIIa (GPIIb/IIIa) is the receptor for fibrinogen, which mediate platelet aggregation and adhesion. We compared the influence of various synthetic dialysis membranes on platelet activation and GPIIb/IIIa in vitro study. Method: 150ml of whole blood (taken from healthy volunteers) was circulated at 20 ml/min for 2 hours in microcircuit through mini-module of polysulfone (PS), vitamin-E modified polysulfone (PS-E), cellulose triacetate (CTA) and polyacrylonitrile-ST (AN-69ST) membrane. Blood samples were drawn at 0, 30,60,90 and 120 minute, and we measured platelets count, plasma level of total-GPIIb/IIIa, bound-GPIIb/IIIa, P-selectin, β-thromboglobulin (β-TG), and platelet factor-4 (PF-4). All experiments were repeated 3 times. Result: Platelet count, total-GPIIb/IIIa, β-TG and PF-4 did not show significantly change during in vitro sessions with any mini-module. The mean change ratio for bound ratio of GPIIb/IIIa(bound-GPIIb/IIIa/total- GPIIb/IIIa) with PS was 98.3 ±19.7%, with PS-E was 8.2±2.3%, with CTA was 33.2±18.5%, with AN-69ST was 21.3±7.7%, and the mean change ratio for P-selectin with PS was 154.2±90.8%, with PS-E was-16.7±5.2%, with CTA was 128.3±93%, with AN-69ST was -3.4±3.6%. The bound ratio of GPIIb/IIIa could be used as a useful marker of the biocompatibility of a dialysis membrane. On platelet aggregation, PS-E and AN-69ST generally afford better biocompatibility than CTA and PS.