Endpoint attachment of unfractionated vs low molecular weight heparin: a comparative study on blood compatibility

IntroductionBlood compatibility is a critical requirement for materials used in medical devices to prevent adverse reactions such as thrombosis and inflammation. Heparin, a natural anticoagulant, is commonly used to coat medical devices such as catheters and stents, mimicking the endothelial glycoca...

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Main Authors: Stephan Harm, Jennifer Zottl, Claudia Schildböck, Christoph Bauer, Denisa Cont, Viktoria Weber
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Materials
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Online Access:https://www.frontiersin.org/articles/10.3389/fmats.2025.1557939/full
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author Stephan Harm
Jennifer Zottl
Claudia Schildböck
Christoph Bauer
Denisa Cont
Denisa Cont
Viktoria Weber
author_facet Stephan Harm
Jennifer Zottl
Claudia Schildböck
Christoph Bauer
Denisa Cont
Denisa Cont
Viktoria Weber
author_sort Stephan Harm
collection DOAJ
description IntroductionBlood compatibility is a critical requirement for materials used in medical devices to prevent adverse reactions such as thrombosis and inflammation. Heparin, a natural anticoagulant, is commonly used to coat medical devices such as catheters and stents, mimicking the endothelial glycocalyx and thereby preventing thrombus formation. While endpoint attached (EPA) heparin surfaces have proven effective in clinical use, concerns have arisen regarding heparin-induced thrombocytopenia (HIT) associated with unfractionated heparin (UFH)-bonded prostheses. Given the lower HIT risk profile of low molecular weight heparin (LMWH), this study aimed to evaluate the blood compatibility of LMWH-functionalized surfaces in comparison to those functionalized with UFH.MethodsConventional 96-well plates and adsorbent materials were functionalized with either UFH or LMWH. The blood compatibility of these surfaces was assessed by analyzing coagulation parameters, platelet adhesion, and leukocyte adhesion. Antithrombin III (AT-III) binding was also examined to understand the anticoagulant mechanism of LMWH-functionalized surfaces.ResultsLMWH-functionalized surfaces demonstrated no significant binding to AT-III. Despite this, both LMWH- and UFH-functionalized surfaces effectively prevented the activation of coagulation triggered by foreign surfaces. Furthermore, there was no observed increase in platelet or leukocyte adhesion on LMWH-functionalized surfaces compared to UFH-functionalized ones, indicating a similar degree of blood compatibility between the two.DiscussionThis study highlights that LMWH can provide blood compatibility comparable to that of UFH when used for surface functionalization, despite its lack of AT-III binding. These findings support the potential of LMWH as a safer alternative to UFH in medical device coatings, particularly in applications where the risk of HIT must be minimized.
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spelling doaj-art-6c5078b7b7ed4871883806caaa9d87ca2025-08-20T02:19:57ZengFrontiers Media S.A.Frontiers in Materials2296-80162025-04-011210.3389/fmats.2025.15579391557939Endpoint attachment of unfractionated vs low molecular weight heparin: a comparative study on blood compatibilityStephan Harm0Jennifer Zottl1Claudia Schildböck2Christoph Bauer3Denisa Cont4Denisa Cont5Viktoria Weber6Department for Biomedical Research, University for Continuing Education Krems, Krems an der Donau, AustriaDepartment for Biomedical Research, University for Continuing Education Krems, Krems an der Donau, AustriaDepartment for Biomedical Research, University for Continuing Education Krems, Krems an der Donau, AustriaDepartment for Health Sciences, Medicine and Research, University for Continuing Education Krems, Krems an der Donau, AustriaDepartment for Biomedical Research, University for Continuing Education Krems, Krems an der Donau, AustriaDepartment of Physiology, Pharmacology and Microbiology, Karl Landsteiner University of Health Sciences, Krems an der Donau, AustriaDepartment for Biomedical Research, University for Continuing Education Krems, Krems an der Donau, AustriaIntroductionBlood compatibility is a critical requirement for materials used in medical devices to prevent adverse reactions such as thrombosis and inflammation. Heparin, a natural anticoagulant, is commonly used to coat medical devices such as catheters and stents, mimicking the endothelial glycocalyx and thereby preventing thrombus formation. While endpoint attached (EPA) heparin surfaces have proven effective in clinical use, concerns have arisen regarding heparin-induced thrombocytopenia (HIT) associated with unfractionated heparin (UFH)-bonded prostheses. Given the lower HIT risk profile of low molecular weight heparin (LMWH), this study aimed to evaluate the blood compatibility of LMWH-functionalized surfaces in comparison to those functionalized with UFH.MethodsConventional 96-well plates and adsorbent materials were functionalized with either UFH or LMWH. The blood compatibility of these surfaces was assessed by analyzing coagulation parameters, platelet adhesion, and leukocyte adhesion. Antithrombin III (AT-III) binding was also examined to understand the anticoagulant mechanism of LMWH-functionalized surfaces.ResultsLMWH-functionalized surfaces demonstrated no significant binding to AT-III. Despite this, both LMWH- and UFH-functionalized surfaces effectively prevented the activation of coagulation triggered by foreign surfaces. Furthermore, there was no observed increase in platelet or leukocyte adhesion on LMWH-functionalized surfaces compared to UFH-functionalized ones, indicating a similar degree of blood compatibility between the two.DiscussionThis study highlights that LMWH can provide blood compatibility comparable to that of UFH when used for surface functionalization, despite its lack of AT-III binding. These findings support the potential of LMWH as a safer alternative to UFH in medical device coatings, particularly in applications where the risk of HIT must be minimized.https://www.frontiersin.org/articles/10.3389/fmats.2025.1557939/fullendpoint attached heparinlow molecular weight heparin (LMWH)unfractionated heparin (UFH)blood compatibilityheparin induce thrombocytopeniacarmeda bioactive surface
spellingShingle Stephan Harm
Jennifer Zottl
Claudia Schildböck
Christoph Bauer
Denisa Cont
Denisa Cont
Viktoria Weber
Endpoint attachment of unfractionated vs low molecular weight heparin: a comparative study on blood compatibility
Frontiers in Materials
endpoint attached heparin
low molecular weight heparin (LMWH)
unfractionated heparin (UFH)
blood compatibility
heparin induce thrombocytopenia
carmeda bioactive surface
title Endpoint attachment of unfractionated vs low molecular weight heparin: a comparative study on blood compatibility
title_full Endpoint attachment of unfractionated vs low molecular weight heparin: a comparative study on blood compatibility
title_fullStr Endpoint attachment of unfractionated vs low molecular weight heparin: a comparative study on blood compatibility
title_full_unstemmed Endpoint attachment of unfractionated vs low molecular weight heparin: a comparative study on blood compatibility
title_short Endpoint attachment of unfractionated vs low molecular weight heparin: a comparative study on blood compatibility
title_sort endpoint attachment of unfractionated vs low molecular weight heparin a comparative study on blood compatibility
topic endpoint attached heparin
low molecular weight heparin (LMWH)
unfractionated heparin (UFH)
blood compatibility
heparin induce thrombocytopenia
carmeda bioactive surface
url https://www.frontiersin.org/articles/10.3389/fmats.2025.1557939/full
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