PMID- 17597089
OWN - NLM
STAT- MEDLINE
DCOM- 20080114
LR  - 20071001
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 22
IP  - 10
DP  - 2007 Oct
TI  - The AN69 ST haemodialysis membrane under conditions of two different 
      extracorporeal circuit rinse protocols a comparison of thrombogenicity 
      parameters.
PG  - 2978-84
AB  - BACKGROUND: Thrombogenicity is an important parameter of haemodialysis (HD) 
      membrane biocompatibility. The surface of the polyacrylonitrile AN69 ST membrane 
      is coated with a polyethylenimine. This modification allows heparin adsorption. 
      The binding of heparin to the membrane surface occurs during priming of the 
      extracorporeal circuit (ECC) by rinsing it with saline and heparin. Our aims were 
      to assess and compare the thrombogenicity of the AN69 ST membrane under 
      conditions of two extracorporeal circuit (ECC) rinse protocols-with and without 
      unfractionated heparin (UFH). METHODS: In a prospective, crossover and randomized 
      study, we examined 10 patients during HD after ECC preparation with either rinse 
      protocols. Prior to HD and at 15, 60 and 240 min, we determined plasma levels of 
      the thrombin-antithrombin complexes (TAT), platelet factor 4 (PF4), heparin 
      concentration (antiXa) and thrombocyte count. Systemic anticoagulation was 
      performed using UFH. RESULTS: During HD after ECC rinse without UFH, there was a 
      significantly earlier and more marked increase in TAT compared with 
      UFH-containing rinse (P <0.05). Using Spearman coefficient, we demonstrated a 
      significant correlation between TAT and antiXa at 60 min (r = -0.534) and 240 min 
      (r = -0.538). A comparison of the TAT/antiXa ratios between rinses at 60 min 
      revealed a significantly higher increase in TAT following UFH-free rinse (P 
      <0.05). There was no difference in PF4 between the rinses. Platelet count did not 
      change significantly during HD using either rinse protocol. CONCLUSION: Based on 
      plasma TAT levels, ECC priming with an UFH-containing solution reduces the 
      thrombogenicity of the AN69 ST membrane. There is no significant difference 
      between both types of priming concerning PF4 and thrombocyte count.
FAU - Richtrova, Pavlina
AU  - Richtrova P
AD  - Department of Internal Medicine I, Charles University, Medical School and 
      Teaching Hospital, Alej Svobody 80, 30460 Plzen, Czech Republic. 
      richtrovap@fnplzen.cz
FAU - Opatrny, Karel Jr
AU  - Opatrny K Jr
FAU - Vit, Ladislav
AU  - Vit L
FAU - Sefrna, Frantisek
AU  - Sefrna F
FAU - Perlik, Radek
AU  - Perlik R
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20070627
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Acrylic Resins)
RN  - 0 (Biocompatible Materials)
RN  - 0 (Hemodialysis Solutions)
RN  - 25014-41-9 (polyacrylonitrile)
RN  - 37270-94-3 (Platelet Factor 4)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Acrylic Resins/chemistry
MH  - Adsorption
MH  - Aged
MH  - Biocompatible Materials
MH  - Blood Platelets/metabolism
MH  - Cross-Over Studies
MH  - Equipment Design
MH  - Female
MH  - Hemodialysis Solutions/*chemistry
MH  - Heparin/chemistry
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Factor 4/chemistry
MH  - Prospective Studies
MH  - Renal Dialysis/*instrumentation/*methods
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Thrombosis
MH  - Time Factors
EDAT- 2007/06/29 09:00
MHDA- 2008/01/15 09:00
CRDT- 2007/06/29 09:00
PHST- 2007/06/29 09:00 [pubmed]
PHST- 2008/01/15 09:00 [medline]
PHST- 2007/06/29 09:00 [entrez]
AID - gfm137 [pii]
AID - 10.1093/ndt/gfm137 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2007 Oct;22(10):2978-84. doi: 10.1093/ndt/gfm137. Epub 
      2007 Jun 27.