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Yao Y, He L, Mei L, Weng Y, Huang J, Wei S, Li R, Tian S, Liu P, Ruan X, Wang D, Zhou F, Lei C. Cell damage evaluation by intelligent imaging flow cytometry. Cytometry A 2023; 103:646-654. [PMID: 36966466 DOI: 10.1002/cyto.a.24731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/22/2023] [Accepted: 03/21/2023] [Indexed: 03/27/2023]
Abstract
Essential thrombocythemia (ET) is an uncommon situation in which the body produces too many platelets. This can cause blood clots anywhere in the body and results in various symptoms and even strokes or heart attacks. Removing excessive platelets using acoustofluidic methods receives extensive attention due to their high efficiency and high yield. While the damage to the remaining cells, such as erythrocytes and leukocytes is yet evaluated. Existing cell damage evaluation methods usually require cell staining, which are time-consuming and labor-intensive. In this paper, we investigate cell damage by optical time-stretch (OTS) imaging flow cytometry with high throughput and in a label-free manner. Specifically, we first image the erythrocytes and leukocytes sorted by acoustofluidic sorting chip with different acoustic wave powers and flowing speed using OTS imaging flow cytometry at a flowing speed up to 1 m/s. Then, we employ machine learning algorithms to extract biophysical phenotypic features from the cellular images, as well as to cluster and identify images. The results show that both the errors of the biophysical phenotypic features and the proportion of abnormal cells are within 10% in the undamaged cell groups, while the errors are much greater than 10% in the damaged cell groups, indicating that acoustofluidic sorting causes little damage to the cells within the appropriate acoustic power, agreeing well with clinical assays. Our method provides a novel approach for high-throughput and label-free cell damage evaluation in scientific research and clinical settings.
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Affiliation(s)
- Yifan Yao
- The Institute of Technological Sciences, Wuhan University, Wuhan, China
| | - Li He
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Liye Mei
- The Institute of Technological Sciences, Wuhan University, Wuhan, China
| | - Yueyun Weng
- The Institute of Technological Sciences, Wuhan University, Wuhan, China
- The Key Laboratory of Transients in Hydraulic Machinery of Ministry of Education, School of Power and Mechanical Engineering, Wuhan University, Wuhan, China
| | - Jin Huang
- The Institute of Technological Sciences, Wuhan University, Wuhan, China
| | - Shubin Wei
- The Institute of Technological Sciences, Wuhan University, Wuhan, China
| | - Rubing Li
- The Institute of Technological Sciences, Wuhan University, Wuhan, China
| | - Sheng Tian
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Pan Liu
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaolan Ruan
- Department of Hematology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Du Wang
- The Institute of Technological Sciences, Wuhan University, Wuhan, China
| | - Fuling Zhou
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Cheng Lei
- The Institute of Technological Sciences, Wuhan University, Wuhan, China
- Suzhou Institute of Wuhan University, Suzhou, China
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Sun W, Zhang J, Shah A, Arias K, Berk Z, Griffith BP, Wu ZJ. Neutrophil dysfunction due to continuous mechanical shear exposure in mechanically assisted circulation in vitro. Artif Organs 2022; 46:83-94. [PMID: 34516005 PMCID: PMC8688241 DOI: 10.1111/aor.14068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/10/2021] [Accepted: 09/04/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Leukocytes play an important role in the body's immune system. The aim of this study was to assess alterations in neutrophil phenotype and function in pump-assisted circulation in vitro. METHODS Human blood was circulated for four hours in three circulatory flow loops with a CentriMag blood pump operated at a flow of 4.5 L/min at three rotational speeds (2100, 2800, and 4000 rpm), against three pressure heads (75, 150, and 350 mm Hg), respectively. Blood samples were collected hourly for analyses of neutrophil activation state (Mac-1, CD62L, CD162), neutrophil reactive oxygen species (ROS) production, apoptosis, and neutrophil phagocytosis. RESULTS Activated neutrophils indicated by both Mac-1 expression and decreased surface expression of CD62L and CD162 receptors increased with time in three loops. The highest level of neutrophil activation was observed in the loop with the highest rotational speed. Platelet-neutrophil aggregates (PNAs) progressively increased in two loops with lower rotational speeds. PNAs peaked at one hour after circulation and decreased subsequently in the loop with the highest rotational speed. Neutrophil ROS production dramatically increased at one hour after circulation and decreased subsequently in all three loops with similar levels and trends. Apoptotic neutrophils increased with time in all three loops. Neutrophil phagocytosis capacity in three loops initially elevated at one hour after circulation and decreased subsequently. Apoptosis and altered phagocytosis were dependent on rotational speed. CONCLUSIONS Our study revealed that the pump-assisted circulation induced neutrophil activation, apoptosis, and functional impairment. The alterations were strongly associated with pump operating condition and duration.
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Affiliation(s)
- Wenji Sun
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jiafeng Zhang
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Aakash Shah
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Katherin Arias
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA,Fischell Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, Maryland, USA
| | - Zachary Berk
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bartley P Griffith
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Zhongjun J Wu
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA,Fischell Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, Maryland, USA
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Kuck L, Simmonds MJ, Chan CHH, Pauls JP, Tansley GD, Feldmann F, McNamee AP. Ex vivo assessment of erythrocyte tolerance to the HeartWare ventricular assist device operated in three discrete configurations. Artif Organs 2020; 45:E146-E157. [PMID: 33236358 DOI: 10.1111/aor.13877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022]
Abstract
Despite technological advances in ventricular assist devices (VADs) to treat end-stage heart failure, hemocompatibility remains a constant concern, with supraphysiological shear stresses an unavoidable reality with clinical use. Given that impeller rotational speed is related to the instantaneous shear within the pump housing, it is plausible that the modulation of pump speed may regulate peak mechanical shear stresses and thus ameliorate blood damage. The present study investigated the hemocompatibility of the HeartWare HVAD in three configurations typical of clinical applications: standard systemic support left VAD (LVAD), pediatric support LVAD, and pulmonary support right VAD (RVAD) conditions. Two ex vivo mock circulation blood loops were constructed using explanted HVADs, in which pump speed and external loop resistance were manipulated to reflect the flow rates and differential pressures reported in configurations for standard adult LVAD (at 3150 rev⸱min-1 ), pediatric LVAD (at 2400 rev⸱min-1 ), and adult RVAD (at 1900 rev⸱min-1 ). Using bovine blood, the mock circulation blood loops were tested at 37°C over a period of 6 hours (consistent with ASTM F1841-97) and compared with static control. Hemocompatibility assessments were conducted for each test condition, examining hematology, hemolysis (absolute and normalized index), osmotic fragility, and blood viscosity. Regardless of configuration, continuous exposure of blood to the VAD over the 6-hour period significantly altered hematological and rheological blood parameters, and induced increased hemolysis when compared with a static control sample. Comparison of the three operational VAD configurations identified that the adult LVAD condition-associated with the highest pump speed, flow rate, and differential pressure across the pump-resulted in increased normalized hemolysis index (NIH; 0.07) when compared with the lower pump speed "off-label" counterparts (NIH of 0.04 in pediatric LVAD and 0.01 in adult RVAD configurations). After normalizing blood residence times between configurations, pump speed was identified as the primary determinant of accumulated blood damage; plausibly, blood damage could be limited by restricting pump speed to the minimum required to support matched cardiac output, but not beyond.
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Affiliation(s)
- Lennart Kuck
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Michael J Simmonds
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Chris Hoi Houng Chan
- School of Engineering and Built Environment, Griffith University, Southport, QLD, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Jo P Pauls
- School of Engineering and Built Environment, Griffith University, Southport, QLD, Australia.,Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Geoff D Tansley
- School of Engineering and Built Environment, Griffith University, Southport, QLD, Australia
| | - Friederike Feldmann
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Antony P McNamee
- Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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Sun W, Wang S, Zhang J, Arias K, Griffith BP, Wu ZJ. Neutrophil injury and function alterations induced by high mechanical shear stress with short exposure time. Artif Organs 2020; 45:577-586. [PMID: 33237583 DOI: 10.1111/aor.13874] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/09/2020] [Accepted: 11/17/2020] [Indexed: 12/15/2022]
Abstract
High mechanical shear stresses (HMSS) can cause damage to blood, which manifests as morphologic changes, shortened life span, biochemical alterations, and complete rupture of blood cells and proteins, leading to the alterations of normal blood function. The aim of this study is to determine the state of neutrophil activation and function alterations caused by HMSS with short exposure time relevant to ventricular assist devices. Blood from healthy donors was exposed to three levels of HMSS (75Pa, 125Pa, and 175Pa) for a short exposure time (0.5 s) using our Couette-type blood-shearing device. Neutrophil activation (Mac-1, platelet-neutrophil aggregates) and surface expression levels of two key functional receptors (CD62L and CD162) on neutrophils were evaluated by flow cytometry. Neutrophil phagocytosis and transmigration were also examined with functional assays. Results showed that the expression of Mac-1 on neutrophils and platelet-neutrophil aggregates increased significantly while the level of CD62L expression on neutrophils decreased significantly after the exposure to HMSS. The Mac-1 expression progressively increased while the CD62L expression progressively decreased with the increased level of HMSS. The level of CD162 expression on neutrophils slightly increased after the exposure to HMSS, but the increase was not significant. The phagocytosis assay data revealed that the ability of neutrophils to phagocytose latex beads coated with fluorescently labeled rabbit IgG increased significantly with the increased level of HMSS. The transmigration ability of neutrophils slightly increased after the exposure to HMSS, but did not reach a significant level. In summary, HMSS with a short exposure time of 0.5 seconds could induce neutrophil activation, platelet-neutrophil aggregation, shedding of CD62L receptor, and increased phagocytic ability. However, the exposure to the three levels of HMSS did not cause a significant change in neutrophil transmigration capacity and shedding of CD162 receptor on neutrophils.
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Affiliation(s)
- Wenji Sun
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shigang Wang
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jiafeng Zhang
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Katherin Arias
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.,Fischell Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, MD, USA
| | - Bartley P Griffith
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Zhongjun J Wu
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.,Fischell Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, MD, USA
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5
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Johnstone P, Mast E, Hughes E, Peng H. Development of a small-scale rotary lobe-pump cell culture model for examining cell damage in large-scale N-1 seed perfusion process. Biotechnol Prog 2020; 36:e3044. [PMID: 32594624 DOI: 10.1002/btpr.3044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 11/12/2022]
Abstract
Perfusion technology has been identified as a process improvement capable of eliminating some of the constraints in cell culture and allows for high cell densities and viabilities. However, when implementing this N-1 seed perfusion platform in large-scale manufacturing, unexpected cell damage was observed as early as Day 1. Given that the shear rate within recirculation hollow fibers was normalized and aligned correctly across bench, pilot, and manufacture scale, the primary mitigation was placed on the rotary lobe pump. Lowering the pump rate in manufacture scale successfully alleviated the cell damage. To understand the source of cell damage within the pump, a small-scale rotary lobe-pump robustness model was developed. Testing different pump flow rates and back pressures, it was concluded that high back pressure can cause cell damage. The back pressure within the system can cause back flow and high shear within small clearances inside the pump, which lead to the primary cell damage observed at a large scale. This shear level can be significantly higher than the shear in the hollow fiber. This pump robustness model can be utilized to aid the perfusion skid design, including pump operation efficiency and cell shear sensitivity. Methods to reduce the back pressure and cell shearing were determined to better predict manufacturing performance in the future.
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Affiliation(s)
| | - Elena Mast
- Manufacturing Sciences, Biogen, Durham, North Carolina, USA
| | - Erik Hughes
- Manufacturing Sciences, Biogen, Durham, North Carolina, USA
| | - Haofan Peng
- Manufacturing Sciences, Biogen, Durham, North Carolina, USA
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6
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Non-physiological shear stress-induced blood damage in ventricular assist device. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2019. [DOI: 10.1016/j.medntd.2019.100024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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7
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Modeling sensitivity and uncertainties in platelet activation models applied on centrifugal pumps for extracorporeal life support. Sci Rep 2019; 9:8809. [PMID: 31217491 PMCID: PMC6584555 DOI: 10.1038/s41598-019-45121-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/29/2019] [Indexed: 11/08/2022] Open
Abstract
Two platelet activation models were studied with respect to uncertainties of model parameters and variables. The sensitivity was assessed using two direct/deterministic approaches as well as the statistical Monte Carlo method. The first two, are linear in character whereas the latter is non-linear. The platelet activation models were applied on platelets moving within an extracorporeal centrifugal blood pump. The phenomenological, Lagrangian stress- and time-based power law-based models under consideration, have experimentally calibrated parameters and the stress expressed in a scalar form. The sensitivity of the model with respect to model parameters and the expression of the scalar stress was examined focusing on a smaller group of platelets associated with an elevated risk of activation. The results showed a high disparity between the models in terms of platelet activation state, found to depend on the platelets’ trajectory in the pump and the expression used for the scalar stress. Monte Carlo statistics was applied to the platelets at risk for activation and not to the entire platelet population. The method reveals the non-linear sensitivity of the activation models. The results imply that power-law based models have a restricted range of validity. The conclusions of this study apply to both platelet activation and hemolysis models.
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8
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Radley G, Ali S, Pieper IL, Thornton CA. Mechanical shear stress and leukocyte phenotype and function: Implications for ventricular assist device development and use. Int J Artif Organs 2018; 42:133-142. [PMID: 30585115 DOI: 10.1177/0391398818817326] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Heart failure remains a disease of ever increasing prevalence in the modern world. Patients with end-stage heart failure are being referred increasingly for mechanical circulatory support. Mechanical circulatory support can assist patients who are ineligible for transplant and stabilise eligible patients prior to transplantation. It is also used during cardiopulmonary bypass surgery to maintain circulation while operating on the heart. While mechanical circulatory support can stabilise heart failure and improve quality of life, complications such as infection and thrombosis remain a common risk. Leukocytes can contribute to both of these complications. Contact with foreign surfaces and the introduction of artificial mechanical shear stress can lead to the activation of leukocytes, reduced functionality and the release of pro-inflammatory and pro-thrombogenic microparticles. Assessing the impact of mechanical trauma to leukocytes is largely overlooked in comparison to red blood cells and platelets. This review provides an overview of the available literature on the effects of mechanical circulatory support systems on leukocyte phenotype and function. One purpose of this review is to emphasise the importance of studying mechanical trauma to leukocytes to better understand the occurrence of adverse events during mechanical circulatory support.
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Affiliation(s)
- Gemma Radley
- Swansea University Medical School, Swansea, UK
- Calon Cardio-Technology Ltd, Institute of Life Science, Swansea, UK
| | - Sabrina Ali
- Calon Cardio-Technology Ltd, Institute of Life Science, Swansea, UK
| | - Ina Laura Pieper
- Swansea University Medical School, Swansea, UK
- Scandinavian Real Heart AB, Västerås, Sweden
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9
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Pieper IL, Radley G, Christen A, Ali S, Bodger O, Thornton CA. Ovine Leukocyte Microparticles Generated by the CentriMag Ventricular Assist Device In Vitro. Artif Organs 2018; 42:E78-E89. [PMID: 29512167 DOI: 10.1111/aor.13068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/06/2017] [Accepted: 10/12/2017] [Indexed: 12/13/2022]
Abstract
Ventricular assist devices (VADs) are a life-saving form of mechanical circulatory support in heart failure patients. However, VADs have not yet reached their full potential due to the associated side effects (thrombosis, bleeding, infection) related to the activation and damage of blood cells and proteins caused by mechanical stress and foreign materials. Studies of the effects of VADs on leukocytes are limited, yet leukocyte activation and damage including microparticle generation can influence both thrombosis and infection rates. Therefore, the aim was to develop a multicolor flow cytometry assessment of leukocyte microparticles (LMPs) using ovine blood and the CentriMag VAD as a model for shear stress. Ovine blood was pumped for 6 h in the CentriMag and regular samples analyzed for hemolysis, complete blood counts and LMP by flow cytometry during three different pump operating conditions (low flow, standard, high speed). The high speed condition caused significant increases in plasma-free hemoglobin; decreases in total leukocytes, granulocytes, monocytes, and platelets; increases in CD45+ LMPs as well as two novel LMP populations: CD11bbright /HLA-DR- and CD11bdull /HLA-DR+ , both of which were CD14- /CD21- . CD11bbright /HLA-DR- LMPs appeared to respond to an increase in shear magnitude whereas the CD11bdull /HLA-DR+ LMPs significantly increased in all pumping conditions. We propose that these two populations are released from granulocytes and T cells, respectively, but further research is needed to better characterize these two populations.
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Affiliation(s)
- Ina Laura Pieper
- Institute of Life Science, Swansea University Medical School, Swansea, UK.,Calon Cardio-Technology Ltd, Institute of Life Science, Swansea, UK
| | - Gemma Radley
- Institute of Life Science, Swansea University Medical School, Swansea, UK.,Calon Cardio-Technology Ltd, Institute of Life Science, Swansea, UK
| | - Abigail Christen
- Calon Cardio-Technology Ltd, Institute of Life Science, Swansea, UK
| | - Sabrina Ali
- Calon Cardio-Technology Ltd, Institute of Life Science, Swansea, UK
| | - Owen Bodger
- Institute of Life Science, Swansea University Medical School, Swansea, UK
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Yu H, Engel S, Janiga G, Thévenin D. A Review of Hemolysis Prediction Models for Computational Fluid Dynamics. Artif Organs 2017. [PMID: 28643335 DOI: 10.1111/aor.12871] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Flow-induced hemolysis is a crucial issue for many biomedical applications; in particular, it is an essential issue for the development of blood-transporting devices such as left ventricular assist devices, and other types of blood pumps. In order to estimate red blood cell (RBC) damage in blood flows, many models have been proposed in the past. Most models have been validated by their respective authors. However, the accuracy and the validity range of these models remains unclear. In this work, the most established hemolysis models compatible with computational fluid dynamics of full-scale devices are described and assessed by comparing two selected reference experiments: a simple rheometric flow and a more complex hemodialytic flow through a needle. The quantitative comparisons show very large deviations concerning hemolysis predictions, depending on the model and model parameter. In light of the current results, two simple power-law models deliver the best compromise between computational efficiency and obtained accuracy. Finally, hemolysis has been computed in an axial blood pump. The reconstructed geometry of a HeartMate II shows that hemolysis occurs mainly at the tip and leading edge of the rotor blades, as well as at the leading edge of the diffusor vanes.
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Affiliation(s)
- Hai Yu
- Laboratory of Fluid Dynamics & Technical Flows, Institute of Fluid Dynamics and Thermodynamics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Sebastian Engel
- Laboratory of Fluid Dynamics & Technical Flows, Institute of Fluid Dynamics and Thermodynamics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Gábor Janiga
- Laboratory of Fluid Dynamics & Technical Flows, Institute of Fluid Dynamics and Thermodynamics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Dominique Thévenin
- Laboratory of Fluid Dynamics & Technical Flows, Institute of Fluid Dynamics and Thermodynamics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Loutherback K, D'Silva J, Liu L, Wu A, Austin RH, Sturm JC. Deterministic separation of cancer cells from blood at 10 mL/min. AIP ADVANCES 2012; 2:42107. [PMID: 23112922 PMCID: PMC3477176 DOI: 10.1063/1.4758131] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 09/21/2012] [Indexed: 05/07/2023]
Abstract
Circulating tumor cells (CTCs) and circulating clusters of cancer and stromal cells have been identified in the blood of patients with malignant cancer and can be used as a diagnostic for disease severity, assess the efficacy of different treatment strategies and possibly determine the eventual location of metastatic invasions for possible treatment. There is thus a critical need to isolate, propagate and characterize viable CTCs and clusters of cancer cells with their associated stroma cells. Here, we present a microfluidic device for mL/min flow rate, continuous-flow capture of viable CTCs from blood using deterministic lateral displacement (DLD) arrays. We show here that a DLD array device can isolate CTCs from blood with capture efficiency greater than 85% CTCs at volumetric flow rates of up to 10 mL/min with no effect on cell viability.
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Affiliation(s)
- Kevin Loutherback
- Princeton Institute for the Science and Technology of Materials (PRISM), Princeton Universtiy, Princeton, NJ, USA ; Department of Electrical Engineering, Princeton University, Princeton, NJ, USA
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12
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13
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Roeloffzen WWH, Kluin-Nelemans HC, Bosman L, de Wolf JTM. Effects of red blood cells on hemostasis. Transfusion 2010; 50:1536-44. [PMID: 20158685 DOI: 10.1111/j.1537-2995.2010.02586.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Currently there is no sensitive laboratory test to establish the influence of red blood cells (RBCs) on hemostasis. As thromboelastography (TEG) measures hemostasis in whole blood, taking into account the interactions of all cellular elements, we used this instrument to investigate the role that RBCs play in hemostasis. STUDY DESIGN AND METHODS In 29 patients with chemotherapy-induced anemia we studied the effect of progressive anemia on the coagulation profile. In 24 patients with chronic anemia we studied the effect of transfusion of RBCs on coagulation. Finally, in 18 patients we evaluated whether storage time of RBCs has additional effects on hemostasis. RESULTS We observed a significant negative correlation between hemoglobin and TEG variables related to both clot strength and elasticity (p < 0.05). Moreover, anemia was associated with a delay in the initiation of the coagulation cascade. Correction of anemia by RBC transfusion resulted in significant shortening of this initiation phase with now the opposite effect on clot strength and elasticity. The negative effects on clot quality were significantly worse when fresh RBCs were transfused compared to longer-stored RBCs. Furthermore, in contrast to the longer-stored RBCs, fresh RBCs did not enhance initial fibrin formation. CONCLUSIONS In this study we found that anemia was associated with a delay in the initiation of the coagulation cascade with a finally formed clot with superior strength and viscoelastic properties. Transfusion of RBCs was associated with impaired clot quality, with even worse effects on the initial fibrin build-up and clot quality by fresh RBCs.
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Affiliation(s)
- Wilfried W H Roeloffzen
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Herreros J, Ubilla M, Berjano EJ, Vila-Nuñez JE, Páramo JA, Sola J, Mercé S. In Vivo Assessment of a New Method of Pulsatile Perfusion Based on a Centrifugal Pump. Artif Organs 2010; 34:140-6. [DOI: 10.1111/j.1525-1594.2009.00769.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Bor-Kucukatay M, Keskin A, Akdam H, Kabukcu-hacioglu S, Erken G, Atsak P, Kucukatay V. Effect of thrombocytapheresis on blood rheology in healthy donors: role of nitric oxide. Transfus Apher Sci 2009; 39:101-8. [PMID: 18707921 DOI: 10.1016/j.transci.2008.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Platelet transfusions are increasingly being used to treat thrombocytopenic conditions. Because of anticoagulation, changes in blood composition and extracorporeal circulation, donor apheresis may cause alterations in hemorheology. This study aimed at investigating the effects of thrombocytapheresis on donor blood rheology. The effect of nitric oxide (NO) on donor red blood cell (RBC) deformability after thrombocytapheresis was also studied. Platelets were collected by a Haemonetics MCS 3p cell seperator. Blood samples were obtained before and 15 min after thrombocytapheresis. RBC deformability and aggregation were measured using an ektacytometer, whole blood viscosity (WBV) was determined with a cone-plate rotational viscometer. Donor RBCs were shown to be less deformable at all stress levels except 0.30 Pa after thrombocytapheresis and NO donor sodium nitroprusside (SNP, 10(-6) M) reversed the reduced deformability caused by thrombocytapheresis. It was observed that donor apheresis induces a decrement in RBC aggregation and WBV measured at standard hematocrit (Hct). No significant alterations were observed in WBV values determined at native Hct values. Thrombocytapheresis also resulted in a decrement in fibrinogen, total protein, cholesterol and albumin levels whereas Hct was found to be increased and serum glucose, triglyceride, hemoglobin levels unaltered after apheresis. These results suggest that, thrombocytapheresis causes alterations in hemorheological parameters and hence in the perfusion of the microvasculature of the donors and NO appears to have a protective effect on the impairment observed in RBC deformability.
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Affiliation(s)
- Melek Bor-Kucukatay
- Pamukkale University, Faculty of Medicine, Department of Physiology, Kinikli, 20070 Denizli, Turkey
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Naumenko KS, Kim SF, Cherkanova MS, Naumenko SE. The Haemonetics(R) Cell Saver 5 washing properties: effect of different washing pump and centrifuge speeds. Interact Cardiovasc Thorac Surg 2008; 7:759-63. [DOI: 10.1510/icvts.2008.183582] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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17
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Carter J, Hristova K, Harasaki H, Smith WA. Short exposure time sensitivity of white cells to shear stress. ASAIO J 2004; 49:687-91. [PMID: 14655735 DOI: 10.1097/01.mat.0000094194.93742.a7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
White cells are a critical functional element circulating in blood. This study sheared fresh whole bovine blood in stainless steel and polymeric capillary tubes of various lengths and diameters. Flow rate was constant, resulting in a range of exposure times and shear stresses. White cell count, cell integrity (trypan blue exclusion), and phagocytic index (latex bead ingestion) were assayed. It was found that cell function declined at lower stresses than cell count. White cell count was maintained at higher stress levels at the short exposure times used here compared with the published results at longer times. This study suggests that function, not count, is the critical parameter when studying shear effects on white cells, and that, like red cells, there may be an exposure time effect and that white cell function is impacted at stresses lower than are required for hemolysis.
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Affiliation(s)
- Janell Carter
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA
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18
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Apel J, Neudel F, Reul H. Computational fluid dynamics and experimental validation of a microaxial blood pump. ASAIO J 2001; 47:552-8. [PMID: 11575836 DOI: 10.1097/00002480-200109000-00031] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Intravascular application of microaxial blood pumps as heart assist devices requires a maximum in size reduction of the pump components. These limitations affect the design process in many ways and restrict the number of applicable experimental procedures, but a detailed knowledge of the hemodynamics of the pump is of great interest for efficiency enhancement and reduction of blood trauma and thrombus formation. Computational fluid dynamics (CFD) offers a convenient approach to this goal. In this study, the inlet, vane, and outlet regions of a microaxial blood pump used as an intraaortic left ventricular assist device are analyzed by CFD and 3-dimensional (3-D) particle tracking velocimetry (PTV). For this purpose, a mock loop is set up that facilitates 3-D flow visualization. Flow in the main part of this testing device is modeled and computed by means of CFD. Pump head/flow (HQ) characteristics, axial pressure distribution, and particle images are then compared with numerical flow data. Results show that the pump performance characteristics, as well as inlet and outlet swirl predicted by the CFD model, are quite accurate compared with measured data. Proper boundary condition definitions and spatial discretization topology requirements for satisfactory results are discussed.
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Affiliation(s)
- J Apel
- Cardiovascular Technology Group, Helmholtz Institute for Biomedical Engineering, Aachen, Germany
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19
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Trittenwein G, Zamberger A, Trittenwein H, Burda G, Golej J, Hermon M, Pollak A. A simple neonatal mock circulation enabling pulsatility and different hemodynamical states for neonatal ECMO research: application to assess the effect of a centrifugal pump operated neonatal ECMO system on the circulation. Artif Organs 1998; 22:414-8. [PMID: 9609351 DOI: 10.1046/j.1525-1594.1998.06154.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In neonates, extracorporeal membrane oxygenation (ECMO) is increasingly used for circulatory support, e.g., after cardiac surgery. For training purposes and for research, animal experiments are usually required, complicated by increasing social issues, high costs, and limited reproducibility. Therefore, we designed a mechanical neonatal mock circulation (NMC) model enabling pulsatility and various hemodynamic conditions commonly occurring in neonates. Connected to a flow and pressure reading interface, a computer assisted data management system was installed. A nonocclusive roller pump combined with stiff and elastic tubing segments (for aortic pressure regulation and venous capacity) as well as constant and variable resistance (and optionally a patent duct) are essential features of the NMC system. To show the investigational potential, we studied the influence of venoarterial and venovenous ECMO on the NMC performance during normal circulation, hypovolemia, high arterial resistance, the combination of both, and in low cardiac output. By assessing the significant effects of ECMO on the circulatory function of the NMC, its feasibility and investigational properties could be demonstrated.
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Affiliation(s)
- G Trittenwein
- Department of Neonatology and Pediatric Intensive Care, University of Vienna, Austria
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Kawahito K, Mohara J, Misawa Y, Fuse K. Platelet damage caused by the centrifugal pump: in vitro evaluation by measuring the release of alpha-granule packing proteins. Artif Organs 1997; 21:1105-9. [PMID: 9335369 DOI: 10.1111/j.1525-1594.1997.tb00450.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Platelets are more vulnerable to damage than erythrocytes because platelets are easily activated by contact with extracorporeal circuits and by exposure to shear forces. However, the degree of platelet damage caused by centrifugal pumps is unclear. To evaluate platelet damage in different pumping conditions, the rates of increase for specific proteins in platelet alpha-granules, beta-thromboglobulin (beta-TG), and platelet factor 4 (PF-4) were measured in both in vitro simulated left ventricular assist device (LVAD) and cardiopulmonary bypass (CPB) conditions and compared with the erythrocyte trauma. A flow of 5.0 L/min with deltaP of 100 mm Hg for LVAD (low pressure head condition) and a flow of 5.0 L/min with deltaP of 350 mm Hg for CPB (high pressure head condition) were investigated. Each condition was tested 4 times for 3 h in a mock circuit with a Capiox (Terumo, Tokyo, Japan) centrifugal pump using fresh human blood. Blood was sampled at 1 h intervals, measuring plasma free hemoglobin (fHb), beta-TG, and PF-4. To evaluate the degree of damage, the rates of increase of fHb, beta-TG, and PF-4 were calculated for each condition as deltafHb/deltaN, deltabeta-TG/deltaN, and deltaPF-4/deltaN where deltafHb is the increase in plasma free hemoglobin, deltabeta-TG is the increase in beta-TG, deltaPF-4 is the increase in PF-4, and deltaN is the increase in the passing number. The passing number is defined in the following equation: N = Qt/V where t is the time, V is the priming volume, and Q is the flow rate. There was no significant difference between the 2 conditions (low pressure head condition versus high pressure head condition) in the rate of increase of fHb (0.0035+/-0.0004 vs. 0.0034+/-0.0010 g/100 L, NS). Contrary to this, the rates of increase for specific proteins in platelet alpha-granules in the high pressure head condition demonstrated a significantly higher rate of increase than in the low pressure head condition. The mean rate of increase for beta-TG in the low pressure head condition was 0.22+/-0.03 ng/ml and in the high pressure head condition was 0.51+/-0.05 ng/ml (p < 0.05). The rate of increase for PF-4 in the low pressure head condition was 0.11+/-0.02 ng/ml and in the high pressure head condition was 0.30+/-0.06 ng/ml (p < 0.05). These results suggest that measurements of beta-TG and PF-4 may be more sensitive parameters than hemolysis for evaluating blood cell trauma and that platelets are more vulnerable to mechanical damage by a centrifugal pump than erythrocytes.
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Affiliation(s)
- K Kawahito
- Jichi Medical School, Department of Cardiovascular Surgery, Tochigi, Japan
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