Evaluation of the Blood Compatibility of Materials, Cells, and Tissues: Basic Concepts, Test Models, and Practical Guidelines

  • Kristina N. EkdahlEmail author
  • Jaan Hong
  • Osama A. Hamad
  • Rolf Larsson
  • Bo Nilsson
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 735)


Medicine today uses a wide range of biomaterials, most of which make contact with blood permanently or transiently upon implantation. Contact between blood and nonbiological materials or cells or tissue of nonhematologic origin initiates activation of the cascade systems (complement, contact activation/coagulation) of the blood, which induces platelet and leukocyte activation.

Although substantial progress regarding biocompatibility has been made, many materials and medical treatment procedures are still associated with severe side effects. Therefore, there is a great need for adequate models and guidelines for evaluating the blood compatibility of biomaterials. Due to the substantial amount of cross talk between the different cascade systems and cell populations in the blood, it is advisable to use an intact system for evaluation.

Here, we describe three such in vitro models for the evaluation of the biocompatibility of materials and therapeutic cells and tissues. The use of different anticoagulants and specific inhibitors in order to be able to dissect interactions between the different cascade systems and cells of the blood is discussed. In addition, we describe two clinically relevant medical treatment modalities, the integration of titanium implants and transplantation of islets of Langerhans to patients with type 1 diabetes, whose mechanisms of action we have addressed using these in vitro models.


Tissue Factor Blood Compatibility Cascade System Therapeutic Cell High Molecular Weight Kininogen 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work was supported by grants from the Swedish Research Council (VR) 2009–4675, 2009–4462, the Swedish Research Council, and the Swedish Research Council/SSF/Vinnova contract grant number 60761701 and by faculty grants from the Linnæus University. Reagents for preparing heparin-coated surfaces were obtained from Corline Systems AB. We thank Dr. Deborah McClellan for excellent editorial assistance and Mr. Hans Nilsson for preparing the illustrations in Fig. 18.1.

Conflict of Interest StatementThe author Professor R. Larsson is an employee of Corline Systems AB, Uppsala, Sweden. None of the other authors has conflicts of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Kristina N. Ekdahl
    • 1
    • 2
    Email author
  • Jaan Hong
    • 1
  • Osama A. Hamad
    • 1
  • Rolf Larsson
    • 1
    • 3
  • Bo Nilsson
    • 1
  1. 1.Department of Immunology, Genetics and Pathology, Rudbeck Laboratory C5:3Uppsala UniversityUppsalaSweden
  2. 2.School of Natural SciencesLinnæus UniversityKalmarSweden
  3. 3.Corline Systems ABUppsalaSweden

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