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Phosphorylcholine coating offers natural platelet preservation during cardiopulmonary bypass

Heart Center, University Hospital-Gent, Gent, Belgium, filip.desomer{at}rug.ac.be

Y Van Belleghem

Heart Center, University Hospital-Gent, Gent, Belgium

F Caes

Heart Center, University Hospital-Gent, Gent, Belgium

K François

Heart Center, University Hospital-Gent, Gent, Belgium

J Arnout

Center for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium

X Bossuyt

Laboratory Medicine, University Hospital-Leuven, Leuven, Belgium

Y Taeymans

Heart Center, University Hospital-Gent, Gent, Belgium

G Van Nooten

Heart Center, University Hospital-Gent, Gent, Belgium

Return of blood activated by tissue factor is the main culprit for triggering the coagulation cascade. When this activated blood is diverted from the cardiopulmonary bypass (CPB) circuit, it becomes possible to evaluate the effect of surface treatment on platelet and complement activation. Twenty adult patients undergoing elective coronary artery bypass grafting (CABG) were randomly assigned either to a control group (n= 10) or to a group in which the CPB circuit was completely coated with phosphorylcholine (n= 10). Plasma concentrations of platelet factor 4 (PF4), ß-thromboglobulin (ßTG), C3, C3d, C4, TCC, thrombin generation, haptoglobin and free haemoglobin, as well as blood loss, were measured. No significant differences between the two groups were found for haemolysis and thrombin generation. The mean total release of PF4 and ßTG during CPB was 9338± 17303 IU/ml/CPB and 3790± 4104 IU/ml/CPB in the coated group versus 22192± 13931 IU/ml/CPB (p= 0.011) and 8040± 3986 IU/ml/CPB (p= 0.005) in the control group. Blood loss was 30% less in the coated group compared to the control group. Phosphorylcholine coating appears to have a favourable effect on blood platelets, which is most obvious after studying the changes during CPB. Clinically, this effect resulted in a 30% reduction in blood loss.

Perfusion, Vol. 17, No. 1, 39-44 (2002)
DOI: 10.1191/0267659102pf526oa


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