In vitro leukocyte adhesion to modified polyurethane surfaces: III. Effect of flow, fluid medium, and platelets on PMN adhesion

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Abstract
The operation of filters used to remove leukocytes from red cell concentrates may depend on the adhesion and mechanical trapping of leukocytes. If adhesion is a major component of filtration then filter materials which augment leukocyte adhesion will be useful. In previous leukocyte adhesion studies, done without flow, poly(ethyleneimene) (PEI) modified polyurethane (PU) films were shown to have greater adhesion when compared with unmodified PU. Since filtration is done under flow conditions, it was decided to study PMN adhesion at a number of flow rates using an established parallel plate flow cell. The influence of divalent cations, plasma and platelets were investigated in the presence of red cells, 40% Hematocrit. The number of adherent PMNs to the PEI modified films was always substantially higher than that for the unmodified ones when the shear rate was set at 30 s-1. When using Tyrode's solution containing albumin, with or without divalent cations, a maximum in PMN adhesion was found between the shear rates of 10 and 100 s-1. With Tyrode's solution containing albumin and with 10% (v/v) plasma in saline, the addition of platelets increased PMN adhesion when divalent cations were absent. Adhesion levels with 10% (v/v) plasma in saline were reduced when compared to Tyrode's solution containing albumin without divalent cations. These results support the use of filtration conditions where the concentration of plasma is reduced and the concentration of divalent cations is increased. Detailed evaluation of filter function with flow rate is also recommended. A cell adhesion promoting polymer coating, such as PEI, may be useful in improving filter efficiency.