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Activation of coagulation during hemodialysis with high biocompatibility membranes without heparin
Suppl. XIII, 1991
ABSTRACTS
99
197 c) NEW MEMBRCINEFOR DICILYSIS REPORTEDLY NOT REQUIRING HEPARIN: EFFECTS SN BLOOD CLOTTING AND PLATELET FUNCTION. G. Palareti. G. Biagi, C. Legnani, (11 (I) S. Stefoni, S. Coccheri. L. Coli, Dept. Angiology and Blood Coagulation and (1) Institute of Nephrology, S. Orsola Hospital, Bologna, Italy. A new synthetic dialytic membrane (Eval, Ethilene-vinyl-alcohol, 1.3 mm surhas been evaluaface area dialyzer), proposed for use also without heparin, ted in comparison with a customarily used membrane (Cuprophane, Cu) in 5 uremic patients chronically (2 males, 5327 y) on regular dialysis treatment at least 6 months. Blood samples were obtained immediately before (but for heparinization when Cu was used, TO) and at the end (before heparin after neutralization, Tl) of dialysis sessions. ____________________________________---------------------------------------aPTT t-PA Platel. FbDP whole blood aggr.(R) BTG set ng/ml x 103mmc ADP co1 lagen release ug/m1 1 ItI
7+1
ng/ml 19462417
16+2 1121
9=1 4?1
37222380 1452f265
Tl 5128 21r2 14r1 .28+.02 175228 _____________________------------~-~~-~~~~~~~~~~~~~~~~~~~-~----------------
821
42SOE64
TO
3322
Tl TO
2922 166+34
.22+.02
9.8k1.9
.52:. 18 .25+.03
1121 9.1kl.6
Eva1
167228 ** 146216 153224
cu
FbDP= nika)
fibrin-derived
; *= p
**=
degradation products (Fibrinostika p
System,
Organon
Tek-
(within the normal values). no other signs for slight FbDP increase Except clotting activation were found with Eval, despite absence of heparin. The of activation were more marked with Cu than with Eval. The of platelet signs and t-PCI antigen levels, recorded in Cu at increase in RTG release marked Tl, may be attributed to heparin administration.
198
ACTIVATION OF COAGULATION DURING HEMODIALYSIS WITH HIGH BIOCOMPATIBILITY MEMBRANES WITHOUT HEPARIN. P.M. Tenconi, M. P. Caramella, S. Casati, P.M. Mannucci. Moia, B.Bottasso, Hemophilia and Thrombosis Center A. Bianchi Bonomi, University of Milano. New hemodialysis membranes made of ethylen vinyl alcohol (EVAL) have been developed. The high biocompatibility of these membranes makes it possible to perform hemodialysis without anticoagulants but it is not known whether they activate the coagulation. We have evaluated activation parameters of blood coagulation in 8 uremic patients on chronic hemodialysis in a cross over randomized study. Each patient underwent hemodialysis twice: without anticoagulants and then with low doses of heparin (2.000 IU). Both fibrinopeptide A and prothrombin fragment 1+2 without hemodialysis during significantly increased anticoagulants but not during hemodialysis with 2.000 IU of We conclude that though more biocompatible, EVAL heparin. membranes induce activation of the coagulation pathway during hemodialysis without anticoagulants. Doses of heparin as low as 2.000 IU are enough to inhibit this activation.
ABSTRACTS
99
197 c) NEW MEMBRCINEFOR DICILYSIS REPORTEDLY NOT REQUIRING HEPARIN: EFFECTS SN BLOOD CLOTTING AND PLATELET FUNCTION. G. Palareti. G. Biagi, C. Legnani, (11 (I) S. Stefoni, S. Coccheri. L. Coli, Dept. Angiology and Blood Coagulation and (1) Institute of Nephrology, S. Orsola Hospital, Bologna, Italy. A new synthetic dialytic membrane (Eval, Ethilene-vinyl-alcohol, 1.3 mm surhas been evaluaface area dialyzer), proposed for use also without heparin, ted in comparison with a customarily used membrane (Cuprophane, Cu) in 5 uremic patients chronically (2 males, 5327 y) on regular dialysis treatment at least 6 months. Blood samples were obtained immediately before (but for heparinization when Cu was used, TO) and at the end (before heparin after neutralization, Tl) of dialysis sessions. ____________________________________---------------------------------------aPTT t-PA Platel. FbDP whole blood aggr.(R) BTG set ng/ml x 103mmc ADP co1 lagen release ug/m1 1 ItI
7+1
ng/ml 19462417
16+2 1121
9=1 4?1
37222380 1452f265
Tl 5128 21r2 14r1 .28+.02 175228 _____________________------------~-~~-~~~~~~~~~~~~~~~~~~~-~----------------
821
42SOE64
TO
3322
Tl TO
2922 166+34
.22+.02
9.8k1.9
.52:. 18 .25+.03
1121 9.1kl.6
Eva1
167228 ** 146216 153224
cu
FbDP= nika)
fibrin-derived
; *= p
**=
degradation products (Fibrinostika p
System,
Organon
Tek-
(within the normal values). no other signs for slight FbDP increase Except clotting activation were found with Eval, despite absence of heparin. The of activation were more marked with Cu than with Eval. The of platelet signs and t-PCI antigen levels, recorded in Cu at increase in RTG release marked Tl, may be attributed to heparin administration.
198
ACTIVATION OF COAGULATION DURING HEMODIALYSIS WITH HIGH BIOCOMPATIBILITY MEMBRANES WITHOUT HEPARIN. P.M. Tenconi, M. P. Caramella, S. Casati, P.M. Mannucci. Moia, B.Bottasso, Hemophilia and Thrombosis Center A. Bianchi Bonomi, University of Milano. New hemodialysis membranes made of ethylen vinyl alcohol (EVAL) have been developed. The high biocompatibility of these membranes makes it possible to perform hemodialysis without anticoagulants but it is not known whether they activate the coagulation. We have evaluated activation parameters of blood coagulation in 8 uremic patients on chronic hemodialysis in a cross over randomized study. Each patient underwent hemodialysis twice: without anticoagulants and then with low doses of heparin (2.000 IU). Both fibrinopeptide A and prothrombin fragment 1+2 without hemodialysis during significantly increased anticoagulants but not during hemodialysis with 2.000 IU of We conclude that though more biocompatible, EVAL heparin. membranes induce activation of the coagulation pathway during hemodialysis without anticoagulants. Doses of heparin as low as 2.000 IU are enough to inhibit this activation.