Exploiting the current paradigm of blood-material interactions for the rational design of blood-compatible materials.

The paradigm of tissue material interactions, which holds that protein adsorption is the first event following contact and determines the later interactions of cells, is invoked to propose a design strategy for biocompatibility. Control of protein interactions is the key element, and it is suggested that nonspecific protein adsorption must be prevented while the adsorption of specific proteins that are expected to result in appropriate bioactivity must be promoted. Modification with polyethylene oxide has been investigated extensively as a means of preventing nonspecific adsorption. Examples of proteins that could be targeted for specific adsorption are antithrombin III to prevent coagulation and albumin to minimize platelet adhesion. Two examples of surfaces designed for specific adsorption from the author's laboratory are discussed: the incorporation of thrombin binding peptides to give a thrombin scavenging surface, and the incorporation of lysine to give a plasminogen specific surface with the potential to dissolve clots.