Permeability Detection Of The Argatroban-anticoagulation-modified-membrane Hemofilter

BackgroundBlood purification is an important therapy for patients with end-stage renal diseases or any other critical diseases. Bleeding or potential bleeding risk during blood purification is the anticoagulant taboo. Fixing anticoagulant drugs on the membrane inner surface can obtain local anticoagulant properties, and avoid systemic use of anticoagulant drugs which increasing bleeding risk. In our group's previous studies, we have successfully constructed a novel kind polysulfone membrane hemofilter, using Friedel-crafts reaction and graft cross-linking techniques between some small moleculars and argatroban as a anticoagulant drug, which owned local anticoagulation function. Also our group's previous studies have confirmed that this new type filter own excellent biocompatibility, which can reduce the activation of coagulation system and decrease filter clotting.ObjectiveNot only a new type hemofilter should have excellent biocompatibility, but also should have well permeability performance. Whether graft small molecules on inner membrane surface will affect the solute and water removal capability of filters. In this study, we evaluate the change of filters permeability performance, and assess the influence of graft cross-linking treatments on the hemofilter.MethodsArgatroban anticoagulation-modified polysulfone membrane filters as the treatment group, and traditional polysulfone membrane filters as the control group. (1) Solute clearance detection. Using small molecules urea and creatinine, middle molecule vitamin B12 and large molecule inulin as the simulated fluid solutes, we detect solutes clearance of this two group filters by means of in vitro imitated hemodialysis, during the closed loop we set simulation fluid rate at 200ml/min, dialysate rate at 500ml/min, ultrafiltration at 0. After one hour dialysis, we collected the arterial, venous and dialysate exit end liquid, measured the solutes concentration of each liquid samples, then calculated the solutes clearance, compareing the solute removal performance of the two group filters.(2)Ultrafiltration performance detection. Using fresh anticoagulati-on bovine blood as research medium, we detect the ultrafiltration performance of the two group filters by means of in vitro ultrafiltration, during the cycle we set the blood flow rate at 200ml/min, transmembrane pressure at 100±10mHg.Collected the ultrafiltrate volume after one hour cycle, calculated and compared the ultrafiltration coefficient of the two group filters.Results(1) The four kinds solutes clearance of the treatment group hemofilters are as follows, urea:162.46±5.22ml/min, creatinine:125.22±2.79ml/min,VitaminB12:85.73±8.71ml/min, inulin:64.78±6.34ml/min.The four kinds solutes clearance of the control group hemofilters are as follows, urea:159.33±8.91ml/min, creatinine:127.53±3.57ml/min,Vita-minB12:84.54±8.72ml/min, inulin:61.82±5.72ml/min., respectively. The solute clearance differences between this two group hemofilters have no statistically significance(P＞0.05). (2)The ultrafiltration coefficient of the treatmeant group is 13.66±0.19ml/(h·mmHg); the ultrafiltration coeffici-ent of the control group is 13.95±0.17ml/(h·mmHg). The differences between them have no statistically significance (P>0.05).ConclusionThe permeability performance of argatroban anticoagulation-modified polysulfone membrane filter is excellent, and the molecule-grafted-cross-linking anticoagulant modified technology have no adverse effect on polysulfone membrane hemofilter.