Perspective and trends for biomaterials.

Biomaterials may be synthetic or of natural origin used in contact with living tissue and biological fluids for prosthetic, diagnostic, therapeutic, and storage applications. The opposing phenomena of clotting and fibrinolysis under physiological conditions significantly influence the biocompatibility of materials. Although smooth-surfaced biomaterials adsorb proteins when in contact with blood, subsequent enzymatic and hemorheological events alter these proteins, thus influencing their biological performance. In contrast to synthetic materials, the healthy, living endothelium exhibits active secretory functions in the maintenance of blood compatibility. The increasingly wide use of biomaterials besides cardiovascular surgery justifies a broad-based approach because too narrow objectives often bypass significant opportunities that are realistic in terms of technological advancement and societal needs.