The surface of biomaterials can induce contacting blood to coagulate, similar to the response initiated by injured blood vessels to control blood loss. This poses a challenge to the use of biomaterials as the resulting coagulation can impair the performance of hemocompatible devices such as catheters, vascular stents and various extracorporeal tubings [1], what can moreover cause severe host reactions like embolism and infarction. Biomaterial induced coagulation processes limit the therapeutic use of medical products, what motivates the need for a better understanding of the basic mechanisms leading to this bio-incompatibility [2] in order to define modification strategies towards improved biomaterials [3]. Several approaches for the enhancement of hemocompatible surfaces include passive and active strategies for surface modifications. The materials’ chemical-physical properties like surface chemistry, wettability and polarity are parameters of passive modification approaches for improved hemocompatibility and are the focus of the present work. In the present study self assembled monolayers with different surface functionalities (-COOH, -OH, -CH3) were applied as well as two-component-layers with varying fractions of these, as they allow a defined graduation of surface wettability and charge. The ease of control over these parameters given by these model surfaces enables the evaluation of the influence of specific surface-properties on biological responses. To evaluate the effects of different surface chemistry on initial mechanisms of biomaterial induced coagulation, the surfaces were incubated with protein solution, human plasma, blood cell fractions or fresh heparinised human whole blood. Indicative hemocompatibility parameters were subsequently analysed focusing on protein adsorption, coagulation activation, contact activation (intrinsic/ enhancer pathway), impact of tissue factor (extrinsic/ activator pathway) and cellular systems (blood platelets and leukocytes).

The surface of biomaterials can induce contacting blood to coagulate, similar to the response initiated by injured blood vessels to control blood loss. This poses a challenge to the use of biomaterials as the resulting coagulation can impair the performance of hemocompatible devices such as catheters, vascular stents and various extracorporeal tubings [1], what can moreover cause severe host reactions like embolism and infarction. Biomaterial induced coagulation processes limit the therapeutic use of medical products, what motivates the need for a better understanding of the basic mechanisms leading to this bio-incompatibility [2] in order to define modification strategies towards improved biomaterials [3]. Several approaches for the enhancement of hemocompatible surfaces include passive and active strategies for surface modifications. The materials’ chemical-physical properties like surface chemistry, wettability and polarity are parameters of passive modification approaches for improved hemocompatibility and are the focus of the present work. In the present study self assembled monolayers with different surface functionalities (-COOH, -OH, -CH3) were applied as well as two-component-layers with varying fractions of these, as they allow a defined graduation of surface wettability and charge. The ease of control over these parameters given by these model surfaces enables the evaluation of the influence of specific surface-properties on biological responses. To evaluate the effects of different surface chemistry on initial mechanisms of biomaterial induced coagulation, the surfaces were incubated with protein solution, human plasma, blood cell fractions or fresh heparinised human whole blood. Indicative hemocompatibility parameters were subsequently analysed focusing on protein adsorption, coagulation activation, contact activation (intrinsic/ enhancer pathway), impact of tissue factor (extrinsic/ activator pathway) and cellular systems (blood platelets and leukocytes).

Hemocompatibility tuning was adopted to explore and refine an innovative, GA-free preparation strategy combining decellularization, riboflavin/UV crosslinking, and low-energy electron irradiation (SULEEI) procedure. A SULEEI-protocol was established to avoid GA-dependent deterioration that results in insufficient long-term aortic valve bioprosthesis durability. Final SULEEI-pericardium, intermediate steps and GA-fixed reference pericardium were exposed in vitro to fresh human whole blood to elucidate effects of preparation parameters on coagulation and inflammation activation and tissue histology. The riboflavin/UV crosslinking step showed to be less efficient in inactivating extracellular matrix (ECM) protein activity than the GA fixation, leading to tissue-factor mediated blood clotting. Intensifying the riboflavin/UV crosslinking with elevated riboflavin concentration and dextran caused an enhanced activation of the complement system. Yet activation processes induced by the previous protocol steps were quenched with the final electron beam treatment step. An optimized SULEEI protocol was developed using an intense and extended, trypsin-containing decellularization step to inactivate tissue factor and a dextran-free, low riboflavin, high UV crosslinking step. The innovative and improved GA-free SULEEI-preparation protocol results in low coagulant and low inflammatory bovine pericardium for surgical application.