In vitro thrombogenicity evaluation of rotary blood pumps by thromboelastometry
Author:
Klein Mario1ORCID, Tack Jana Christine1, Mager Ilona1, Maas Judith1, Schmitz-Rode Thomas1, Arens Jutta12ORCID, Steinseifer Ulrich1, Clauser Johanna Charlotte1ORCID
Affiliation:
1. Department of Cardiovascular Engineering , Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty, RWTH Aachen University , Aachen , Germany 2. Chair in Engineering Organ Support Technologies, Department of Biomechanical Engineering , Faculty of Engineering Technology, University of Twente , Enschede , The Netherlands
Abstract
Abstract
In vitro thrombogenicity tests for rotary blood pumps (RBPs) could benefit from assessing coagulation kinematics, as RBP design improves. In this feasibility study, we investigated if the method of thromboelastometry (TEM) is able to assess coagulation kinematics under the in vitro conditions of RBP tests. We conducted in vitro thrombogenicity tests (n=4) by placing Deltastream® DP3 pumps into test loops that were filled with 150 mL of slightly anti-coagulated porcine blood, adjusted to an activated clotting time (ACT) well below clinically recommended levels. Blood samples were taken at certain time points during the experiment until a continuous decrease in pump flow indicated major thrombus formation. Blood samples were analyzed for ACT, platelet count (PLT), and several TEM parameters. While visible thrombus formation was observed in three pumps, ACT indicated an ongoing activation of coagulation, PLT might have indicated platelet consumption. Unexpectedly, most TEM results gave no clear indications. Nonetheless, TEM clotting time obtained by non-anticoagulated and chemically non-activated whole blood (HEPNATEM-CT) appeared to be more sensitive for the activation of coagulation in vitro than ACT, which might be of interest for future pump tests. However, more research regarding standardization of thrombogenicity pump tests is urgently required.
Publisher
Walter de Gruyter GmbH
Subject
Biomedical Engineering
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