Development of a Method for Visualizing and Quantifying Thrombus Formation in Extracorporeal Membrane Oxygenators

Purpose: Extracorporeal membrane oxygenation (ECMO) is a life-saving critical care technology that presents significant risks of medical device-associated thrombosis. We developed a complete method for collecting membrane oxygenators (membrane lung) from patients receiving ECMO treatment and quantitatively analyzing the distribution of thrombus formation within the membrane. Methods: We collected used membrane oxygenators from patients for processing and imaging with microcomputed tomography (microCT). We reconstructed the microCT data and performed image segmentation to identify regions of thrombus formation within these oxygenators. We performed density mapping to quantify thrombus volume across different regions of each oxygenator and within multiple oxygenator models. Results: Our method yields two-dimensional and three-dimensional visualization and quantification of thrombus deposition in ECMO. Analysis of the spatial distribution of platelet deposition, red blood cell entrapment, and fibrin formation within the fouled device provides insights into the structural patterns of oxygenator thrombosis. Conclusions: This method can enable quantification of oxygenator thrombosis which can be used for evaluating the effect of new biomaterial or pharmacological approaches for mitigating vascular device-associated thrombosis during ECMO.