Strategies to improve chitosan hemocompatibility: A review

Due to its remarkable physicochemical and biological properties, chitosan is one of the most promising polymers for biomedical applications. The cationic nature of chitosan may induce thrombosis making it unsuitable as blood – contacting material. Nevertheless, in the last decade many researchers are attempting to modulate the biopolymer-blood interactions and to develop hemocompatible chitosan derivatives, which will broaden the biopolymer applications. This paper provides an overview of the strategies used to enhance chitosan hemocompatibility, focusing on two specific topics: (i) strategies based on chemical modifications of chitosan and (ii) strategies based on association of this biopolymer with compounds that exhibit complementary properties. It also highlights the current progress in the design of hemocompatible functionalized chitosan-based systems for biomedical applications such as: drug delivery, central nervous system disease treatment, theragnosis and cardiovascular applications.