Self-anticoagulant sponge for whole blood auto-transfusion and its mechanism of coagulation factor inactivation

Tao Xu, Haifeng Ji (), Lin Xu, Shengjun Cheng, Xianda Liu, Yupei Li, Rui Zhong, Weifeng Zhao (), Jayachandran N. Kizhakkedathu and Changsheng Zhao
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Tao Xu: Sichuan University
Haifeng Ji: Sichuan University
Lin Xu: Sichuan University
Shengjun Cheng: Sichuan University
Xianda Liu: Sichuan University
Yupei Li: Sichuan University
Rui Zhong: Chinese Academy of Medical Sciences, Peking Union Medical College
Weifeng Zhao: Sichuan University
Jayachandran N. Kizhakkedathu: University of British Columbia, 2350 Health Sciences Mall, Life Sciences Centre
Changsheng Zhao: Sichuan University

Nature Communications, 2023, vol. 14, issue 1, 1-20

Abstract: Abstract Clinical use of intraoperative auto-transfusion requires the removal of platelets and plasma proteins due to pump-based suction and water-soluble anticoagulant administration, which causes dilutional coagulopathy. Herein, we develop a carboxylated and sulfonated heparin-mimetic polymer-modified sponge with spontaneous blood adsorption and instantaneous anticoagulation. We find that intrinsic coagulation factors, especially XI, are inactivated by adsorption to the sponge surface, while inactivation of thrombin in the sponge-treated plasma effectively inhibits the common coagulation pathway. We show whole blood auto-transfusion in trauma-induced hemorrhage, benefiting from the multiple inhibitory effects of the sponge on coagulation enzymes and calcium depletion. We demonstrate that the transfusion of collected blood favors faster recovery of hemostasis compared to traditional heparinized blood in a rabbit model. Our work not only develops a safe and convenient approach for whole blood auto-transfusion, but also provides the mechanism of action of self-anticoagulant heparin-mimetic polymer-modified surfaces.

Date: 2023
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DOI: 10.1038/s41467-023-40646-7

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