An autologous blood-derived patch as a hemostatic agent: evidence from thromboelastography experiments and a porcine liver punch biopsy model

IF 4.2 3区医学 Q2 ENGINEERING, BIOMEDICAL

Journal of Materials Science: Materials in Medicine Pub Date : 2023-04-19 DOI:10.1007/s10856-023-06726-2

Morten P. R. Eskildsen, Otto Kalliokoski, Marie Boennelycke, Rasmus Lundquist, Annette Settnes, Ellen Loekkegaard

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Abstract

Perioperative bleeding is a common complication in surgeries that increases morbidity, risk of mortality, and leads to increased socioeconomic costs. In this study we investigated a blood-derived autologous combined leukocyte, platelet, and fibrin patch as a new means of activating coagulation and maintaining hemostasis in a surgical setting. We evaluated the effects of an extract derived from the patch on the clotting of human blood in vitro, using thromboelastography (TEG). The autologous blood-derived patch activated hemostasis, seen as a reduced mean activation time compared to both non-activated controls, kaolin-activated samples, and fibrinogen/thrombin-patch-activated samples. The accelerated clotting was reproducible and did not compromise the quality or stability of the resulting blood clot. We also evaluated the patch in vivo in a porcine liver punch biopsy model. In this surgical model we saw 100% effective hemostasis and a significant reduction of the time-to-hemostasis, when compared to controls. These results were comparable to the hemostatic properties of a commercially available, xenogeneic fibrinogen/thrombin patch. Our findings suggest clinical potential for the autologous blood-derived patch as a hemostatic agent.

Graphical Abstract

Abstract Image

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自体血源性贴片作为止血剂:来自血栓弹性成像实验和猪肝穿刺活检模型的证据

围手术期出血是一种常见的手术并发症，它增加了发病率、死亡率风险，并导致社会经济成本的增加。在这项研究中，我们研究了血液来源的自体联合白细胞、血小板和纤维蛋白贴片作为一种在外科环境中激活凝血和维持止血的新手段。我们使用血栓弹性成像(TEG)评估了从贴片中提取的提取物对体外凝血的影响。自体血源性贴片激活止血，与未激活的对照、高岭土激活的样品和纤维蛋白原/凝血酶贴片激活的样品相比，平均激活时间缩短。加速凝血是可重复的，并且不会损害所产生的血凝块的质量或稳定性。我们还在猪肝穿刺活检模型中对该贴片进行了体内评估。在这个手术模型中，与对照组相比，我们看到100%的有效止血和明显缩短的止血时间。这些结果与市售的异种纤维蛋白原/凝血酶贴片的止血性能相当。我们的发现提示了自体血源性贴片作为止血剂的临床潜力。图形抽象

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来源期刊

Journal of Materials Science: Materials in Medicine 工程技术-材料科学：生物材料

CiteScore

8.00

自引率

0.00%

发文量

审稿时长

3.5 months

期刊介绍： The Journal of Materials Science: Materials in Medicine publishes refereed papers providing significant progress in the application of biomaterials and tissue engineering constructs as medical or dental implants, prostheses and devices. Coverage spans a wide range of topics from basic science to clinical applications, around the theme of materials in medicine and dentistry. The central element is the development of synthetic and natural materials used in orthopaedic, maxillofacial, cardiovascular, neurological, ophthalmic and dental applications. Special biomedical topics include biomaterial synthesis and characterisation, biocompatibility studies, nanomedicine, tissue engineering constructs and cell substrates, regenerative medicine, computer modelling and other advanced experimental methodologies.