Download PDF
Thromb Haemost 1992; 67(04): 413-416
DOI: 10.1055/s-0038-1648462
Original Articles
Schattauer GmbH Stuttgart

Platelet and Fibrinogen Survival in Calves Implanted with Artificial Heart and Ventricular Assist Device -Correlation with Autopsy Findings

Hamid Al-Mondhiry
The Departments of Medicine and Surgery, The Pennsylvania State University, College of Medicine, The Milton S. Hershey Medical Center, Hershey, PA, USA
,
Walter E Pae
The Departments of Medicine and Surgery, The Pennsylvania State University, College of Medicine, The Milton S. Hershey Medical Center, Hershey, PA, USA
,
Cynthia A Miller
The Departments of Medicine and Surgery, The Pennsylvania State University, College of Medicine, The Milton S. Hershey Medical Center, Hershey, PA, USA
,
William S Pierce
The Departments of Medicine and Surgery, The Pennsylvania State University, College of Medicine, The Milton S. Hershey Medical Center, Hershey, PA, USA
› Author Affiliations
Further Information

Publication History

Received 15 May 1991

Accepted after revision 29 October 1991

Publication Date:
03 July 2018 (online)

  PDF Download  Permissions and Reprints

Summary

The two main ingredients of blood clots formed on artificial surface are platelets and fibrinogen. In this study, we measured platelet and fibrinogen survival in calves implanted with total artificial heart (TAH) and left ventricular assist device (LVAD), and correlate these data with autopsy findings. Platelet survival with autologous 111In-labeled platelets was performed on nine calves implanted with TAH and five with LVAD. Fibrinogen survival with 131I-labeled homologous fibrinogen was performed on six calves with TAH and three with LVAD. Platelet survival was significantly shortened in both groups of animals: 5.89 ± 0.52 days, control 6.46 ± 0.31 days, p = 0.0013; fibrinogen survival was normal: 8.79 ± 1.20 days, control 8.64 ± 1.16 days. At autopsy two calves with TAH had multiorgan thromboembolism. Two other animals with TAH and four with LVAD had focal renal infarcts. Most animals had minor clot formation within the prosthetic device. Major septic complications occurred in four calves with TAH and one with LVAD. Continuous platelet activation by artificial surface probably explains the shortened platelet survival and thromboembolic complications.

 

  • References

  • 1 Salzman EW, Merrill EW. Interaction of blood with artificial surfaces. In: Hemostasis and Thrombosis. 2nd. edition Colman RW, Hirsh J, Marder VJ, Salzman EW. (eds) J. B. Lippincott; Philadelphia, PA: 1987. pp 1335-1347
    Google Scholar
  • 2 Clagett GP. Artificial devices in clinical practice. In: Hemostasis and Thrombosis. 2nd edition. Colman RW, Hirsh J, Marder VJ, Salzman EW. (eds) J. B. Lippincott; Philadelphia, PA: 1987. pp 1348-1365
    Google Scholar
  • 3 Baier RE, Dutton RC. Initial events in interactions of blood with a foreign surface. J Biomed Mater Res 1969; 3: 191-206
    CrossrefPubMedGoogle Scholar
  • 4 Scarborough DE, Mason RG, Dalldorf PG, Brinkhous KM. Morphological manifestations of blood-solid interfacial reactions: A scanning and transmission electron microscopic study. Lab Invest 1969; 20: 164-169
    PubMedGoogle Scholar
  • 5 Packham MA, Evans G, Glynn MF, Mustard JF. The effect of plasma proteins on the interaction of platelets with glass surfaces. J Lab Clin Med 1969; 73: 686-697
    PubMedGoogle Scholar
  • 6 Zucker MG, Vroman L. Platelet adhesion induced by fibrinogen adsorbed onto glass. Soc Exp Biol Med 1969; 131: 318-320
    CrossrefPubMedGoogle Scholar
  • 7 Salzman EW, Lindon J, McManama G, Ware JA. Role of fibrinogen in activation of platelets by artificial surfaces. Ann NY Acad Sci 1987; 516: 184-199
    CrossrefPubMedGoogle Scholar
  • 8 Cross MJ. Effect of fibrinogen on the aggregation of platelets by adenosine diphosphate. Thromb Diath Haemorrh 1964; 12: 524-527
    PubMedGoogle Scholar
  • 9 Niewiarowski S, Budzynski AZ, Lipinski B. Significance of the intact polypeptide chains of human fibrinogen in ADP-induced platelet aggregation. Blood 1977; 49: 635-644
    PubMedGoogle Scholar
  • 10 Harker LA, Slichter SJ. Platelet and fibrinogen consumption in man. N Engl J Med 1972; 287: 999-1005
    CrossrefPubMedGoogle Scholar
  • 11 Green R, Liska J, Egberg N, Koul B, Ljungberg B, Blomback M, Vesterqvist O, Semb B. Hemostatic disturbances associated with implantation of an artificial heart. Thromb Res 1987; 48: 349-362
    CrossrefPubMedGoogle Scholar
  • 12 Ring ME, Feinberg WM, Levinson MM, Bruck DC, Smith RG, Icenogle TM, Copeland JG. Platelet and fibrin metabolism in recipients of the Jarvik 7 total artificial heart. J Heart Transplant 1989; 8: 225-232
    PubMedGoogle Scholar
  • 13 Al-Mondhiry H, Pierce WS. Hemostatic abnormalities in two patients implanted with total artificial hearts. Artif Organs 1989; 13: 464-469
    PubMedGoogle Scholar
  • 14 Nossel HL, Ti M, Kaplan KL, Spandonis K, Soland T, Butler Jr VP. The generation of fibrinopeptide A in clinical blood samples. Evidence for thrombin activity. J Clin Invest 1976; 58: 1136-1144
    CrossrefPubMedGoogle Scholar
  • 15 Kaplan KL, Owen J. Plasma levels of betathromboglobulin and platelet factor 4 as indices of platelet activation in vivo. Blood 1981; 57: 199-202
    PubMedGoogle Scholar
  • 16 Al-Mondhiry H, Pae W, Rosenberg G, Pierce W. Hematologic abnormalities and thromboembolic complications in calves implanted with pneumatic artificial hearts. Long-term studies and autopsy findings. Trans Am Soc Artif Organs 1989; 35: 238-241
    CrossrefPubMedGoogle Scholar
  • 17 Pierce WS, Donachy JH, Landis DL, Brighton JA, Rosenberg G, Migllore JJ, Prophet GA, White WJ, Waldhausen HA. Prolonged mechanical support of the left ventricle. Circulation 1978; 58 (Suppl) (01) 1-133-1-146
    PubMedGoogle Scholar
  • 18 Pierce WS, Parr GVS, Myers JL, Pae Jr WE, Bull A, Waldhaussen JA. Ventricular assist pumping in patients with cardiogenic shock after cardiac operations. N Engl J Med 1981; 305: 1606-1610
    CrossrefPubMedGoogle Scholar
  • 19 Shaffer LJ, Donachy JH, Rosenberg G. et al Total artificial heart implantation in calves with pump of an angled port design. ASAIO Trans 1979; 25: 254-259
    CrossrefPubMedGoogle Scholar
  • 20 Pierce WS, Myers JL, Donachy JH. et al Approaches to the artificial heart. Surgery 1981; 90: 137-148
    PubMedGoogle Scholar
  • 21 Takeda Y. Studies of the metabolism and distribution of fibrinogen in healthy men with autologous 125I-labeled fibrinogen. J Clin Invest 1966; 45: 103-111
    CrossrefPubMedGoogle Scholar
  • 22 Marchalonis JJ. An enzymatic method for the trace iodination of immunoglobulins and other proteins. Biochem J 1969; 113: 299-305
    CrossrefPubMedGoogle Scholar
  • 23 Clauss A. Gerinnungsphysiologische Schnellmethode zur Bestim-mung des Fibrinogens. Acta Hematol 1957; 17: 237-246
    CrossrefPubMedGoogle Scholar
  • 24 Al-Mondhiry H, Pierce WS, Richenbacher W. Platelet survival and function in animals with prosthetic mitral valve: The effect of nafazatrom. Thromb Hemostas 1984; 52: 99-101
    PubMedGoogle Scholar
  • 25 Riba AL, Thakur ML, Gottschalk A, Andriole VT, Zaret BL. Imaging experimental infective endocarditis with Indium-111 labeled blood cellular components. Circulation 1978; 59: 336-343
    PubMedGoogle Scholar
  • 26 Marguerie GA, Plow EF, Edgington TS. Human platelets possess an inducible and saturable receptor specific for fibrinogen. J Biol Chem 1979; 254: 5337-5363
    PubMedGoogle Scholar
  • 27 Knudson DL, Buckley SM. Invertebrate cell culture methods for the study of invertebrate-associated animal viruses. In: Methods in Virology. Maramorsch K, Kaprowski H. (eds) Academic Press; New York: 1977. p 345
    Google Scholar
  • 28 Scheffell U, McIntyre PA, Evatt B, Dvornicky Jr JA, Natarayan TK, Bolling DR, Murphy EH. Evaluation of Indium-111 as a new high photon yield gamma emitting “physiological” platelet label. Johns Hopkins Med J 1977; 140: 285-293
    PubMedGoogle Scholar
  • 29 Spero JA, Lewis JH, Hasiba U. Disseminated intravascular coagulation findings in 346 patients. Thromb Haemostas 1980; 43: 28-33
    PubMedGoogle Scholar
  • 30 Colucci M, Parmo JA, Collen D. Generation in plasma of a fast acting inhibitor of plasminogen activator in response to endotoxin stimulation. J Clin Invest 1985; 75: 818-824
    CrossrefPubMedGoogle Scholar
  • 31 Moore KL, Andreoli SP, Esmon NL, Esmon CT, Bang NU. Endotoxin enhances tissue factor and suppresses thrombomodulin expression of human vascular endothelium in vitro. J Clin Invest 1987; 79: 124-130
    CrossrefPubMedGoogle Scholar
  • 32 Miiller-Berghaus G. Pathophysiologic and biochemical events in disseminated intravascular coagulation: Dysregulation of procoagulant and anticoagulant pathways. Semin Thromb Hemostas 1989; 15: 58-87
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Philippe J, Offner F, Declerck PJ, Leroux-Roels G, Vogelaers D, Baele G, Collen D. Fibrinolysis and coagulation in patients with infectious disease and sepsis. Thromb Haemostas 1991; 65: 291-295
    PubMedGoogle Scholar