Approximately 80% of patients beginning hemodialysis (HD) in the United States use a catheter at treatment initiation, and 18.6% of all HD patients were using a catheter in 2017. However, the hemodialysis catheters (HDC) used for longer-term dialysis in patients have a high complication rate because of infections and dysfunction, with a catheter dysfunction rate of 0.5–3.42 episodes/1000 catheter-days. The most common catheter-related problems are infections (catheter-related bloodstream infections; CRBSI) and thrombosis.
Fibrin sheath formation has a close relationship with pathogen colonization and biofilm formation on the catheter surface. The entry of pathogens into the bloodstream through extraluminal and intraluminal routes and the seeding of pathogens that develop biofilm on the catheter surface cause CRBSI. In the US, annual HD treatment costs ~$89,000 per patient, with total costs of $42 billion. In 2016, 80% of patients used a catheter at initiation of HD and 18.6% of all HD patients in the US were using a catheter in 2017. However, no available solutions to prevent catheter dysfunction can successfully prevent both thrombosis and infection.
The slippery omniphobic coating offered by FreeFlow Medical Devices stops the adhesion of all biological components (bacteria, fungi, blood components) to the surface of medical devices by immobilizing a thin layer of highly inert and biocompatible perfluorinated liquid. We are currently investigating its efficacy in eliminating fibrin sheath development in vivo using a previously developed large pig model.