Abstract
The specific hemocompatibility properties of mechanical-circulatory-support (MCS)-pump technologies have not previously been described in a comparable manner. We thus investigated the hemocompatibility-indicating marker of a new magnetically-levitated (MagLev) centrifugal pump (MT-Mag) in a human, whole-blood mock-loop for 360 min using the MCS devices as a driving component. We compared those results with the CentriMag adult (C-Mag) device under the same conditions according to ISO10993-4. Blood samples were analyzed via enzyme-linked-immunosorbent-assay (ELISA) for markers of coagulation, complement system, and the inflammatory response. The time-dependent activation of the coagulation system was measured by detecting thrombin-anti-thrombin complexes (TAT). The activation of the complement system was determined by increased SC5b-9 levels in both groups. A significant activation of neutrophils (PMN-elastase) was detected within the C-Mag group, but not in the MT-Mag group. However, the amount of PMN-elastase at 360 min did not differ significantly between groups. The activation of the complement and coagulation system was found to be significantly time-dependent in both devices. However, coagulation activation as determined by the TAT level was lower in the MT-Mag group than in the C-Mag group. This slight disparity could have been achieved by the optimized secondary flow paths and surface coating, which reduces the interaction of the surface with blood.
Highlights
The specific hemocompatibility properties of mechanical-circulatory-support (MCS)-pump technologies have not previously been described in a comparable manner
The blood flow of the CentriMag adult (C-Mag) group was maintained at 5.0 ± 0.2 L/min, and in the magnetically-levitated (MagLev) centrifugal pump (MT-Mag) group, the rotation speed of the MT-Mag was set to 1650–1770 rpm, resulting in a flow of 5.0 ± 0.2 L/min, while the rotation speed of the C-Mag was higher, ranging from 2300 to 2500 rpm
Erythrocyte counts were stable within the C-Mag and MT-Mag groups throughout the 360 min of our experiment (C-Mag: 4.6 ± 0.06 × 106 /μl vs. 4.6 ± 0.02 × 106 /μl, p = 0.85; MTMag: 4.5 ± 0.1 × 106 /μl vs. 4.4 ± 0.1 × 106 /μl, p = 0.63) (Fig. 2)
Summary
The specific hemocompatibility properties of mechanical-circulatory-support (MCS)-pump technologies have not previously been described in a comparable manner. We investigated the hemocompatibility-indicating marker of a new magnetically-levitated (MagLev) centrifugal pump (MT-Mag) in a human, whole-blood mock-loop for 360 min using the MCS devices as a driving component. We compared those results with the CentriMag adult (C-Mag) device under the same conditions according to ISO10993-4. Bearings immersed in blood share the potential risk of thrombus formation in the bearing area[9,10,11] To reduce this potential risk of such pumps, magnetic levitation technologies have been proposed that offer a lower risk of thrombosis and more durable performance for the mid-term support of extracorporeal circulation. The individual hemocompatibility properties of various pump technologies have not been compared in the same experimental model
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