Patent Publication Number: US-7585412-B2

Title: Specialized hollow fiber membranes for plasmapheresis and ultrafiltration

Description:
RELATED APPLICATIONS 
     This application is a continuation-in-part of U.S. application Ser. No. 10/959,918, filed Oct. 6, 2004, now U.S. Pat. No. 7,195,711, which is a continuation-in-part of U.S. application Ser. No. 10/666,185, filed Sep. 17, 2003, now U.S. Pat. No. 6,802,971, and which is a divisional of U.S. application Ser. No. 09/549,131, filed Apr. 13, 2000, now U.S. Pat. No. 6,802,820, each of which is incorporated by reference herein in its entirety, and each of which is hereby made a part of this specification. 
    
    
     BACKGROUND OF THE INVENTION 
     In U.S. Pat. Nos. 6,802,820 and 6,802,971 there are disclosed specialized hollow fiber membranes having unique and highly efficient asymmetric fiber wall characteristics capable of separating plasma from whole blood in-vivo by exposing the exterior surface of the fiber to whole blood and directing plasma through the fiber wall. Pumping means is used to create a trans-membrane pressure (TMP) and motivate the flow of fluid from within the in-vivo system, whereby blood plasma is pumped from the patient to a treatment means such as a dialyzer apparatus in which toxic metabolic waste in the plasma is removed. After the plasma is treated for removal of waste products, excess fluids, toxins, and/or other deleterious plasma proteins, the treated plasma is returned and reintroduced to the patients&#39; blood stream. Such methods are referred to as plasma dialysis, ultrafiltration, or blood purification. The aforesaid patents are incorporated herein by reference in their entirety. 
     In conventional hemodialysis procedures hollow fiber membranes are used in the ex-vivo dialysis and hemofilter cartridges for blood purification. The blood is routed from the body through the center lumen of the hollow fibers in the cartridges and dialysate fluid is routed over the outside walls of the fibers within the cartridge cavity in counter-flow direction to blood flow. Thus, toxin diffusion and ultrafiltration are from inside the fiber lumen to a compartment outside the fiber walls where the ultrafiltrate and toxin-saturated dialysate are collected for further processing and/or disposal. 
     Conventional hollow fiber membranes commercially used for present hemodialysis, hemo-ultrafiltration, and dialyzer cartridges fabricated from proprietary and non-proprietary polymer compositions generally utilize two types of morphologies: symmetrical and asymmetrical. In a symmetrical composition, the basic morphology or cellular structure and porosity of the fiber wall is uniform from the inner lumen to the outside surface. In asymmetrical compositions, both morphology and pore structures vary from the inner lumen to the outer surface to meet the high pressure requirements of the filter cartridges in which the TMP inside the fiber lumen is high (100-300 mmHg) while the blood flow itself in the fibers is near stagnant (2-300 ml/min/7,000 fibers=0.042 ml/m/fiber). Such conventional fiber membranes generally have poor elongation and breaking strength and are not suitable for the demanding environment of the in-vivo, high blood flow (vena cava=2.5 1/min), low TMP (≦50 mmHg), and unencapsulated environment of plasma extraction devices described by the aforesaid patent applications. 
     SUMMARY OF THE INVENTION 
     The specialized hollow fiber membranes described herein are capable of separation of plasma and/or plasma components from blood and have the unique morphology, performance properties and materials characteristics necessary for effective and optimal separation and extraction of plasma and plasma components from the blood in either in-vivo or ex-vivo systems. The hollow fiber membrane is tubular in shape and generally circular in cross-section, having a coaxial inner lumen along the length of the fiber in its center. The wall volume of the fibers is asymmetrical with a variable morphology from the outer diameter to that of the inner diameter, having a higher mass density and smaller mean pore diameter at the outer wall and a lower mass density and larger mean pore diameter at the inner wall. The preferred fibers described herein are characterized by having an average elongation breaking force strength of at least about 0.2 lbs. and preferably above about 0.3 lbs: and an average elongation of at least about 45%, preferably above about 60% and more preferably above about 65%. The walls of preferred fibers are also characterized by a continuum of void bounded by solid frames, a continuous change in mass density from the outer wall surface to the inner wall surface, and substantially without macrovoids. The fibers are designed to facilitate plasmapheresis and for ultrafiltration by exposing the outside of the fiber to whole blood within a patient&#39;s blood vessel or in a plasma separation or ultrafiltration module and separating plasma and/or plasma components from the blood through the fiber wall from the outside in. The separated plasma or ultrafiltrate (exudate) may be discarded, or treated by cascade filtration means, dialysis (solute diffusion) means, or other methods known to the art, and returned to the patient. The inner lumen of all fibers in a fiber extraction assembly are in direct fluid communication with means for transporting the exudate. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a schematic end view of a hollow fiber illustrating the membrane morphology structure having four zones; 
         FIG. 2  is a scanning electron microscopy (SEM) image of a cross-section of a portion of the fiber of the invention at 400× magnification showing four zones of the asymmetrical wall structure between the inner and outer fiber wall surfaces; 
         FIG. 3  shows a portion of a cross-section of a portion of the fiber at a magnification of 5,000×; 
         FIG. 4  is a SEM cross-section of Zones 1, 2 and 3 of the fiber shown in  FIG. 2  at a magnification of 1,000×; 
         FIG. 5  is a SEM cross-section of Zones 3 and 4 of the fiber shown in  FIG. 2  at a magnification of 1,000×; 
         FIG. 6  shows a transverse view of the inner lumen wall of the fiber at a magnification of 5,000×; and 
         FIG. 7  is a SEM cross-section of a typical fiber at 100× magnification showing the asymmetrical wall structure. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     As illustrated in  FIGS. 1-7 , the features of the fiber wall of the membrane of the invention include a pore and void structure defined within frames or solid walls which form boundaries of the pores. The pores are voids of variable definitive sizes which permit passage of fluid through the fiber wall to the lumen and which pores obstruct the passage of components larger than the pore diameter. As illustrated particularly in  FIG. 3 , the pores are irregular-shaped voids bounded by solid frames to form irregular tortuous paths for irregular and regular-shaped solutes. The wall structure of the fiber from the outer surface to the lumen is a continuum with non-linear pore and void distribution. The resulting structure is a continuous change in mass density between the outer surface of the fiber and the inner lumen surface and whereby the pore size gradually changes between the fiber wall surfaces. The fiber wall illustrated is substantially without macrovoids. The fiber wall structure of the elongated microporous fibers is asymmetrical between the inner wall surface extending along the interior fiber lumen and the outer fiber wall surface exposed to blood in the vessel in which the filter device is implanted. The fiber wall at or adjacent to the outer wall surface has a higher mass density than the mass density adjacent to or at the inner wall surface. The mass density is a function of the average nominal pore size. Such asymmetric fiber wall morphology is illustrated in  FIG. 7  showing a scanning electron microscopy (SEM) image of a cross-section of the fiber at 100× magnification. It will be observed that the structure of the fiber from the outer surface to the lumen is substantially a continuous change in mass density whereby the pore size gradually changes between these fiber wall surfaces. It is convenient to describe these changes in mass density as sections of the wall area having an average nominal pore size, porosity and wall mass in terms of zones having macro-functions. The different mass density sections or zones of the wall area have an average nominal pore size or average pore diameter, each zone having a different average nominal pore size. The walls may be characterized by two or more zones, for example 2, 3, or 4 or more mass density zones. 
     By way of example,  FIG. 1  schematically illustrates a cross-section of a typical fiber wall having four zone sections, each zone characterized by a different mass pore density based on the average nominal pore size in the respective zones. The section of Zone 1 is adjacent to the fiber outer surface or outer diameter. Zone 1 forms the fiber interface with the permeate blood flow and, although being the thinnest zone, contains the highest density of operationally controlling pores for determining the fiber membrane performance and filtration characteristics, including the composition and components of separated plasma, and controls fiber membrane performance. Thus, Zone 1 has the principal effect in the filtration process for controlling the trans-membrane flux (TMF) which is dependent on pore size, porosity and virtual membrane thickness. Nominal average pore diameters in Zone 1 are between about 0.3 μm and about 1 μm, and preferably range from about 0.4 μm to about 0.8 μm. A preferred filtration sizing has a cutoff of about 0.6 μm to about 0.8 μm. 
     Zones 2 and 3 are designed to decrease the flow path tortuosity and maintain the structural integrity required of the fiber exposed to physical conditions within the body. Pore size distribution in these zones may range gradually from about 0.8 μm to about 1.2 μm and from about 1.2 μm to about 2.5 μm, respectively. The section of Zone 2, while having some flux-controlling pores, is principally a structural member for providing strength to the fiber as well as acting as a conduit for exudate flow to the section of Zone 3. The latter is principally a structural member with expanded pores for reducing the hydraulic resistance and providing a fluid conduit to the lumen of the fiber, and thus, in the example, as shown, has little filtration function. Zone 4, representing the largest area having relatively large voids and pore diameters with little solid structure, has the primary function of a major reduction of hydraulic resistance through the membrane and defines the fiber inner lumen surface. Nominal average pore diameters in this lowest mass density zone are between about 1 μm and about 60 μm, and preferably between about 2 μm and about 6 μm. A typical fiber as shown has an OD of about 730±90 μm, an ID of about 230±70 μm and a wall thickness of about 245±75 μm. The pore sizes and zone dimensions given above are by way of example only. 
       FIG. 2  illustrates a cross-section of the fiber wall showing the structure of Zones 1-4 at 400× magnification. The fiber wall morphology demonstrates the continuum of expanding porosity and open spaces from the virtual control pore size of Zone 1 adjacent to the outer fiber diameter to the very open and low-flow resistant structure in Zone 4 adjacent to the inner lumen wall. 
       FIG. 3 , a cross-section of Zone 1 at a magnification of 5,000×, shows pores and their boundary solid wall frames and the high uniformity of pore geometry and diverse irregular shapes of the individual pore dimensions. It is this high uniformity of pore size and high porosity as well as the thinness of Zone 1 which produces the high separation efficiency and high TMF of the membrane. 
       FIG. 4  shows a cross-section of Zones 1, 2 and 3 at a magnification of 1,000× to illustrate the transition of the high-density structure of Zone 1 in comparison to the more open densities of Zones 2 and 3, as well as the uniformity and continuity of fiber structure producing high tensile and elongation strength. 
       FIG. 5 , also at a magnification of 1,000×, shows the structure of Zones 3 and 4 to illustrate the rapidly expanding open spaces and fluid communication channels which produce the lowered hydraulic resistance to flow of the exudate and results in a very high TMF as a function of a very low TMP. 
       FIG. 6  is a 5,000× magnification of a transverse view of the inner lumen wall showing the highly open but contiguous nature of the structure at that site, facilitating fluid communication of the exudate from the flow through the fiber to the fiber lumen. 
     The driving force for convective transport of the plasma and solutes across the membrane is the transmembrane flux (TMF) equal to P f × TMP (and linear below the critical flow limit) where P f  is the hydraulic permeability of the membrane, and:
 
 P   f =( nπr   p   4 )/(τμΔ x )
 
     where: 
     (n)=Porosity (number of pores/unit area) 
     (π)=3.14159 
     (r p )=Pore radius (pore size) 
     (τ)=Tortuosity of flow path 
     (μ)=Viscosity of solution 
     (Δx)=Membrane thickness 
     The largest leverage to obtaining optimum TMF is the radius of the pores because it is raised to the fourth power, and thus the access fluid flow rate is increased exponentially. The next largest lever is the porosity or number of such pores/unit area and the effect of the pore radius which is multiplied by the porosity. Functional optimization for this application therefore also relies on achieving a tight standard deviation of pore radius in the effective zone of filtration as well as a high density of such pores in the primary filtration zone of the membrane. The relationship is also affected by temperature to the extent that temperature changes the value of the parameters including the viscosity of the solution. 
     The membranes described herein may be prepared using any suitable polymer which will result in a hollow fiber membrane which meets the required biocompatibility requirements and properties. Such membrane materials and surfaces must be highly biocompatible and resist clotting, protein adhesion, and detrimental interaction with immune system components. Thus, the functional convection extraction efficiency of such hollow fibers must be suitable to meet clinical treatment requirements. The membranes also must be designed with a morphology capable of separating plasma from whole blood by filtering from the outside to the inside (lumen) of the fiber. A number of potentially suitable polymer fiber membrane materials include polyurethane, polypropylene, polysulfone, polyethersulfone, polycarbonate, nylon, polyimide and other synthetic resins known to those skilled in the art. A preferred polymer is polysulfone, and more preferably a polyethersulfone blended with polyethylene oxide and/or polyethylene glycol or a polysulfone modified with a polyethylene oxide-polyethylene glycol copolymer. Such polysulfone fibers are produced in the presence of polymer dopes, core fluids, and coagulation fluids using processes including membrane spinning methods which achieve the desired product. Examples of such additive materials used in the polymerization process, spinning process and/or fiber membrane production include polyvinyl pyrrolidone, N-methyl pyrrolidone, dimethyl acetamide, dimethyl sulfoxide, and mixtures of two or more such materials. Such polysulfone fibers have been found to have the least detrimental characteristics that influence protein membrane interaction such as crystallinity, ionic groups, hydrogen bonding groups and hydrophobic sites. The specific method used for producing the aforesaid polymers as well as the processes and parameters during the manufacture are known to those skilled in the art, for example, PCT Publication WO 90/04609. 
     The fibers described herein are characterized by an average elongation breaking force strength of at least about 0.2 lbs. and preferably at least about 0.25 lbs., and an average elongation of at least about 45%, preferably above 60% and more preferably 65% or more. By of example, tests of a polyethersulfone/polyethylene oxide polymer blend hollow fiber having a nominal inner diameter of 230 μm and outer diameter of 730 μm were tested for tensile strength, percent elongation and breaking force according to ASTM D 3822-01 standard methods. The results are shown in the following table: 
     
       
         
           
               
               
               
               
             
               
                   
               
               
                 Sample 
                 Break Strength (lbs) 
                 % Elongation 
                 Tensile (psi) 
               
               
                   
               
             
            
               
                  1 
                 0.352 
                 76.7% 
                 748 
               
               
                  2 
                 0.335 
                 60.0% 
                 712 
               
               
                  3 
                 0.379 
                 75.8% 
                 806 
               
               
                  4 
                 0.375 
                 75.2% 
                 797 
               
               
                  5 
                 0.360 
                 75.7% 
                 765 
               
               
                  6 
                 0.355 
                 69.5% 
                 755 
               
               
                  7 
                 0.343 
                 68.5% 
                 729 
               
               
                  8 
                 0.334 
                 63.6% 
                 710 
               
               
                  9 
                 0.363 
                 69.2% 
                 772 
               
               
                 10 
                 0.341 
                 65.8% 
                 725 
               
               
                 11 
                 0.340 
                 70.5% 
                 723 
               
               
                 12 
                 0.354 
                 61.2% 
                 753 
               
               
                 13 
                 0.366 
                 72.4% 
                 778 
               
               
                 14 
                 0.324 
                 70.2% 
                 689 
               
               
                 15 
                 0.358 
                 77.7% 
                 761 
               
               
                 16 
                 0.342 
                 66.6% 
                 727 
               
               
                 17 
                 0.393 
                 72.9% 
                 835 
               
               
                 18 
                 0.346 
                 74.5% 
                 736 
               
               
                 19 
                 0.339 
                 71.5% 
                 721 
               
               
                 20 
                 0.353 
                 77.8% 
                 750 
               
               
                 AVG 
                 0.353 
                 70.8% 
                 750 
               
               
                   
               
            
           
         
       
     
     The fibers described herein may be used in plasma separation filter devices such as described in U.S. Pat. No. 6,899,692 and in therapeutic apheresis apparatus described in U.S. Pat. No. 6,849,183. The descriptions of the aforesaid patents are incorporated in their entirety herein. 
     Specifications and variation range of parameters for preferred hollow fiber membranes described herein for medical applications are as follows: 
     
       
         
           
               
            
               
                   
               
               
                 PLASMAPHERESIS APPLICATIONS 
               
            
           
           
               
               
               
            
               
                   
                   
                 RANGE OF 
               
               
                   
                 SPECIFICATIONS 
                 APPLICATION 
               
            
           
           
               
               
               
               
               
            
               
                 PARAMETER 
                 FROM 
                 TO 
                 FROM 
                 TO 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 Outer Diameter μm 
                 640 
                 820 
                 200 
                 1000 
               
               
                 Inner Diameter μm 
                 160 
                 300 
                 50 
                 700 
               
               
                 Wall Thickness μm 
                 170 
                 320 
                 50 
                 600 
               
               
                 Zone 1 mean flow pore 
                 0.15 
                 0.95 
                 0.10 
                 1 
               
               
                 diameter μm 
               
               
                 Zone 4 pores @ ID 
                 5 
                 40 
                 1 
                 60 
               
               
                 diameter μm 
               
               
                 Tensile force @ Break 
                 600 
                 1200 
                 500 
                 1500 
               
               
                 Pounds/in 2   
               
               
                 % Elongation @ Break 
                 &gt;45 
                 100 
                 45 
                 150 
               
               
                 Elongation Break Strength 
                 &gt;0.3 
                 1.0 
                 0.15 
                 1.0 
               
               
                 (lbs. @ break) 
               
               
                 Fluid Flux (H 2 0) 
                 &gt;1.0 
                 12 
                 1.0 
                 30 
               
               
                 ml/min/cm 2  @ 100 mmHg 
               
               
                 TMF plasma 
                 &gt;0.25 
                 3 
                 .5 
                 9 
               
               
                 ml/min/cm 2 /100 mmHg 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
            
               
                   
               
               
                 ULTRAFILTRATION APPLICATIONS 
               
            
           
           
               
               
               
            
               
                   
                   
                 RANGE OF 
               
               
                   
                 SPECIFICATIONS 
                 APPLICATION 
               
            
           
           
               
               
               
               
               
            
               
                 PARAMETER 
                 FROM 
                 TO 
                 FROM 
                 TO 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 Outer Diameter μm 
                 640 
                 820 
                 200 
                 1000 
               
               
                 Inner Diameter μm 
                 160 
                 300 
                 50 
                 700 
               
               
                 Wall Thickness μm 
                 170 
                 320 
                 50 
                 600 
               
               
                 Zone 1 mean flow pore 
                 0.003 
                 0.005 
                 0.003 
                 0.006 
               
               
                 diameter μm 
               
               
                 Zone 4 pores @ ID 
                 5 
                 40 
                 1 
                 60 
               
               
                 diameter μm 
               
               
                 TMF H 2 O 
                 0.15 
                 2 
                 0.15 
                 9 
               
               
                 ml/min/cm 2 /500 mmHg 
               
               
                 Tensile force @ Break 
                 600 
                 1200 
                 500 
                 1500 
               
               
                 Pounds/in 2   
               
               
                 Elongation @ Break % 
                 &gt;45 
                 100 
                 45 
                 150 
               
               
                 Elongation Break Strength 
                 &gt;0.3 
                 1.0 
                 0.15 
                 1.0 
               
               
                 (lbs. @ break) 
               
               
                   
               
            
           
         
       
     
     Examples of medical applications for which the hollow fiber membranes of the present invention may be used include the following: therapeutic apheresis applications including plasma exchange, cascade protein separation by filtration, cascade protein removal or modification by adsorption cartridge, cryogenic modification, or chemical adaptation as described in U.S. Pat. No. 6,849,183; fluid management application or congestive heart failure both acute and chronic; tissue engineering applications including online generation of media for bioreactor from xenogenic, allogenic, and autogenic sources as described in U.S. Pat. No. 6,607,501; continuous renal replacement therapy (CRRT) for both acute and chronic kidney failure; edema prevention therapies for MODS (multiple organ dysfunction syndrome) as described in U.S. Pat. No. 6,632,192; cytokine removal or modification in therapy for septic shock or SIRS (systemic inflammatory response syndrome); plasma extraction from peritoneal ascites; intermittent hemodialysis (IHD) or hemodiafiltration; and ARDS (acute respiratory distress syndrome) therapy by reduction of pulmonary edema and physiological pulmonary dead space. 
     All references cited herein, including but not limited to published and unpublished applications, patents, and literature references, are incorporated herein by reference in their entirety and are hereby made a part of this specification. To the extent publications and patents or patent applications incorporated by reference contradict the disclosure contained in the specification, the specification is intended to supersede and/or take precedence over any such contradictory material. 
     The term “comprising” as used herein is synonymous with “including,” “containing,” or “characterized by,” and is inclusive or open-ended and does not exclude additional, unrecited elements or method steps. 
     All numbers expressing quantities of ingredients, reaction conditions, and so forth used in the specification are to be understood as being modified in all instances by the term “about.” Accordingly, unless indicated to the contrary, the numerical parameters set forth herein are approximations that may vary depending upon the desired properties sought to be obtained. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of any claims in any application claiming priority to the present application, each numerical parameter should be construed in light of the number of significant digits and ordinary rounding approaches. 
     The above description discloses several methods and materials of the present invention. This invention is susceptible to modifications in the methods and materials, as well as alterations in the fabrication methods and equipment. Such modifications will become apparent to those skilled in the art from a consideration of this disclosure or practice of the invention disclosed herein. Consequently, it is not intended that this invention be limited to the specific embodiments disclosed herein, but that it cover all modifications and alternatives coming within the true scope and spirit of the invention.