Background: Despite systemic anticoagulation, loss of function of the artificial lung (e.g., oxygenator) remains common. Moreover, the exchange of these artificial organs can be life-threatening as they interrupt continuous support. Current research suggests that cellular activation leading to thrombosis, cellular debris, or hollow-fiber breakdown may be cause of circuit occlusion. The purpose of this study is to develop a method to quantify cellular deposition to determine the source of oxygenator failure. Methods: Seven Getinge Quadrox-iD and one Medtronic Nautilus oxygenators were collected after component failure. Oxygenators were rinsed with saline, fixed with an ethanol-based solution and frozen for processing. The oxygenators were then dissected, and oxygenator fibers were sampled randomly from the inlet surface. Samples were imbedded in an optimum cutting temperature compound, frozen, sliced to 25 mm sections and mounted using a novel ultraviolet tape transfer system. Nucleated cells, fibrinogen, platelets, and proteins for DNA expression (Histone 3) and clot initiation (tissue factor) were stained using immunofluorescence. A square-root transformation was used to normalize all the fluorescence data. Results: There was no difference in gross cell deposition or clot between the Getinge or Medtronic oxygenators. The average nucleated cell count was 102 (min: 4.00; max 546) surrounding a cross-section of an oxygenator hollow-fiber. Fibrinogen deposition was increased in distal sections compared to sections obtained closer to the blood inlet (p < 0.01). Histone 3 was also increased in the distal sections compared to sections closer to the blood inlet (p < 0.03). Tissue factor expression was greater in the oxygenators obtained from patients on venovenous compared to venoarterial support (p < 0.03). Conclusion: Improving understanding of oxygenator failure needs protocolized assessments of the hollow fibers that provide gas exchange. This method of dissection maintains the architecture of the hollow-fiber providing reproducible cellular deposition data and the opportunity for multiple modes of analysis. Quantitative histological evaluation of oxygenator membranes may provide important information to evaluate novel coatings and anticoagulants.Figure 1. Immunofluorescent stain of hollow fiber oxygenator tube with cellular deposition. Leukocytes stained with blue (DAPI), fibrinogen stained green, and platelets (CD61) stained red.