The impact of crystallographic plane orientation as an unexplored terrain in hemocompatible material design

Thrombogenicity causes significant complications in the application of blood-contacting implants, requiring strategies to prevent adverse coagulation reactions. The thrombotic responses to the foreign surfaces are mainly driven by surficial factors such as surface energy, topography, and electrochemical interactions. Although anticoagulation therapies reduce the risks of clotting, patients might still encounter bleeding complications. Therefore, rather than high-risk anticoagulation therapies to counteract coagulation, it is essential to ensure hemocompatibility through the materials intrinsic properties. Endothelialization is crucial in preventing thrombotic complications, with various strategies explored for facilitating endothelial cell adhesion and proliferation. We investigated the impact of crystallographic anisotropy on endothelial and blood cell interactions on four main planes (A-, C-, M-, and R-planes) of single crystalline alumina (-Al2O3, sapphire). Employing advanced surface characterization techniques, including SIMS, KPFM and Zeta potential measurements, our study sheds light on the hemocompatibility of biomaterials considering anisotropic effects. We elucidated that the A-plane of alumina promotes endothelialization and suppresses platelet activation in contrast to other crystallographic planes. Our investigation into cell-surface interactions provides valuable insights and contributes to the advanced biomaterial design, ultimately leading to enhanced clinical outcomes.