American Society of Hirudotherapy

Heparin-coated cardiopulmonary bypass circuits: current status.

Review published in Perfusion (2001)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsDrug DevelopmentHsu · Perfusion, 2001

Abstract

Heparin-coated circuits have been subjected to vigorous testing, both experimentally and clinically, for the past decade. When the functions of heparin are preserved on the surface, the heparinized surface plays multiple roles in attenuating the systemic inflammatory response. These include the ability to attenuate contact activation, coagulation activation, complement activation and, directly or indirectly, platelet and leukocyte activation. The heparinized surface also renders the cardiopulmonary bypass (CPB) circuits hydrophilic and protein resistant and augments lipoprotein binding. The multifunctional nature of the heparinized surface contributes to the overall biocompatibility of the surface. Clinically, heparin-coated circuits become most effective in reducing systemic inflammatory response and in improving morbidity, mortality, and other patient outcome related parameters when material-independent blood activation is controlled or minimized through a global biocompatibility strategy. Techniques involved in the global biocompatibility strategy are readily available and are being effectively and safely practiced at several centers. With the global biocompatibility strategy, outstanding and reproducible results have been routinely achieved with conventional CPB techniques. Alternative revascularization procedures should equal or surpass conventional CPB, using best clinically proven strategies with respect to patient outcome and long-term graft patency.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnticoagulantsAntithrombin IIIBlood CoagulationBlood Coagulation FactorsBlood Transfusion, AutologousCardiopulmonary BypassClinical Trials as TopicCoated Materials, BiocompatibleComplement ActivationCytokinesFibrinolysisHeparin

Summary

Heparin-coated circuits have been subjected to vigorous testing, both experimentally and clinically, for the past decade. When the functions of heparin are preserved on the surface, the heparinized surface plays multiple roles in attenuating the systemic inflammatory response.

Why This Matters for Hirudotherapy

This review examines heparin-coated cardiopulmonary bypass (CPB) circuits, describing how surface-bound heparin attenuates the systemic inflammatory response by reducing contact activation, coagulation activation, complement activation, and platelet/leukocyte activation when combined with a global biocompatibility strategy. The authors discuss the multifunctional nature of the heparinized surface and compare conventional CPB outcomes to alternative revascularization procedures. For ASH's domain, this article has no direct connection to hirudotherapy or the leech secretome — it concerns heparin-bonded biomaterial surfaces rather than leech-derived anticoagulants. No leeches, hirudin, or leech-related substances are mentioned. Its relevance is limited to general background on anticoagulant surfaces in extracorporeal circulation, which is tangential to ASH's focus on therapeutic leech application and leech-derived bioactive molecules.

Citation

Heparin-coated cardiopulmonary bypass circuits: current status.

Hsu · Perfusion, 2001

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