Effect of the expression of CD62P and thrombin generation on patients using central venous catheters for hemodialysis

The formation of thrombi in medical devices that come into contact with blood is a common cause of increased morbidity and mortality. Prolonged use of central venous catheters (CVCs) may cause high infection rates or compromise CVC patency due to thrombus development. In this study, we sought insigh...

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Bibliographic Details
Published in:Artificial organs 2020-03, Vol.44 (3), p.296-304
Main Authors: Lucas, Thabata Coaglio, Carvalho, Maria das Graças, Duarte, Rita Carolina Figueiredo, Haniel, Jonathas, Trindade, Sissy Araújo, Ottoni, Marcelo Henrique Fernandes, Santos, Luara Isabela, Brito Alvim de Melo, Gustavo Eustáquio, Huebner, Rudolf
Format: Article
Language:English
Subjects:
Activation analysis
Blood
Catheters
central venous catheters
Coagulation
Hemodialysis
Insertion
Medical equipment
Medical instruments
Morbidity
Platelets
Renal failure
Thrombin
thrombin generation test
Thrombosis
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Summary:The formation of thrombi in medical devices that come into contact with blood is a common cause of increased morbidity and mortality. Prolonged use of central venous catheters (CVCs) may cause high infection rates or compromise CVC patency due to thrombus development. In this study, we sought insights into possible changes in the hemostatic system during prolonged use of inserted CVCs for hemodialysis by assessing platelets by CD62P and CD41a expression and the potential for thrombin generation (TG). This study included patients with chronic renal failure who were undergoing hemodialysis three times a week using a CVC, and healthy subjects as controls. The participants were distributed into three groups: Group 1: clinically and laboratorially healthy individuals matched by sex and age to the patients (controls); Group II: patients who had completed 1 month of CVC insertion; and Group III: the same patients after they had completed 4 months of CVC insertion. Platelet activation analysis and TG evaluation were performed using blood samples obtained through two different accesses, that is, through a peripheral vein and directly from the CVC lumen. The data showed platelet activation and an increase in the generation of thrombin, particularly after 4 months of CVC use. The results also indicated that insertion of the catheter into the blood stream stimulated the intrinsic rather than the extrinsic pathway. Taken together, the data showed a direct relationship between the use of CVCs in hemodialysis patients and a state of hypercoagulability, most likely associated with endothelial damage and the contact of the medical device with blood components such as platelets and coagulation factors.
ISSN:0160-564X
1525-1594
DOI:10.1111/aor.13568