Hemocompatibility of Blood Purification Materials: Concepts, Mechanisms, and Characterization Techniques

Since the mid-20th century, the development of different blood therapy modalities has ushered significant interest in blood-contacting materials. However, irrespective of the nature of the materials, whether they are synthetic or natural, most materials generate undesirable interactions with blood components unlike our blood vessels. These blood filtration materials often induce various forms of blood incompatibility, including hemolysis, platelet binding, coagulation, complement activation, and cell adhesion. These adverse reactions can further exacerbate patient outcomes as is evident from clinical studies. Thus, it is crucial to enhance the hemocompatibility of blood-contacting materials, and this effort begins with understanding how blood components interact with blood purification materials. In this chapter, we provide information on how blood-contacting materials can induce protein adsorption, hemolysis, coagulation, immune activation, cell adhesion, and the inter-connectivity between these biological pathways augmenting adverse blood interactions. Finally, we elaborate on the current standard methods used for assessing the hemocompatibility of blood-contacting materials.