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In vitro methodology for medical device material thrombogenicity assessments: A use condition and bioanalytical proof‐of‐concept approach
Author(s) -
Wolf Michael F.,
Girdhar Gaurav,
Anderson Arielle A.,
Ubl Samantha R.,
Thinamany Sinduja,
Jeffers Hannah N.,
DeRusha Courtney E.,
RodriguezFernandez Jenny,
Hoffmann Sebastian,
Strief Carrie A.
Publication year - 2021
Publication title -
journal of biomedical materials research part b: applied biomaterials
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.665
H-Index - 108
eISSN - 1552-4981
pISSN - 1552-4973
DOI - 10.1002/jbm.b.34705
Subject(s) - thrombogenicity , biomedical engineering , in vivo , materials science , platelet , platelet activation , in vitro , antithrombin , heparin , medicine , surgery , chemistry , biology , biochemistry , microbiology and biotechnology
Device manufacturers and regulatory agencies currently utilize expensive and often inconclusive in vivo vascular implant models to assess implant material thrombogenicity. We report an in vitro thrombogenicity assessment methodology where test materials (polyethylene, Elasthane™ 80A polyurethane, Pebax®), alongside positive (borosilicate glass) and negative (no material) controls, were exposed to fresh human blood, with attention to common blood‐contact use conditions and the variables: material (M), material surface modification (SM) with heparin, model (Mo), time (T), blood donor (D), exposure ratio (ER; cm 2 material/ml blood), heparin anticoagulation (H), and blood draw/fill technique (DT). Two models were used: (1) a gentle‐agitation test tube model and (2) a pulsatile flow closed‐loop model. Thrombogenicity measurements included thrombin generation (thrombin‐antithrombin complex [TAT] and human prothrombin fragment F1.2), platelet activation (β‐thromboglobulin), and platelet counts. We report that: (a) thrombogenicity was strongly dependent ( p < .0001) on M, H, and T, and variably dependent ( p < .0001 – > .05) on Mo, SM, and D (b) differences between positive control, test, and negative control materials became less pronounced as H increased from 0.6 to 2.0 U/ml, and (c) in vitro‐to‐in vivo case comparisons showed consistency in thrombogenicity rankings on materials classified to be of low, moderate, and high concern. In vitro methods using fresh human blood are therefore scientifically sound and cost effective compared to in vivo methods for screening intravascular materials and devices for thrombogenicity.