Figure 4.

Thrombus formation on hemodialysis membrane after exposure to blood during dialysis. The bioincompatible membrane causes rupturing of red blood cells during HD and induces platelet adhesion and protein adsorption, which induces a coagulation cascade to form a thrombus. After adsorption on the dialyzer membrane, fibrinogen and vWF undergo conformational changes. The conformational changes in fibrinogen and vWF uncover more binding domains to platelets and trigger activation of platelets, blood coagulation, and thrombosis. vWF = von Willebrand factor.