Low grafting density is a disadvantage both in reverse atom transfer radical polymerization (RATRP) and ATRP. In this work, the surfaces of polyurethane (PU) were treated by LaCl3 center dot 6H(2)O to obtain modified surfaces with hydrated layers. The reaction of surface-initiated RATRP was carried out easily, which may be attributed to the enriched hydroxyl groups on the hydrated layers. An innovation found in this work is that some free lanthanum ions (La3+) reacted with the silane coupling agent (CPTM) and the product served as mixed ligand complex. The mixed ligand complex instead of conventional 2,2'-bipyridine was adopted to serve as a ligand in the process of RATRP. As a result, PU surfaces grafted with well-defined polymer brushes (MPC) were obtained. PU substrates before and after modification were characterized by FTIR, XPS, AFM, SEM, SCA, respectively. The results showed that zwitterionic brushes were successfully fabricated on the PU surfaces (P(MPC)), and the content of the grafted layer increased gradually with polymerization time with the grafting density as high as 97.9%. The blood compatibility of the PU substrates was evaluated by plasma recalcification profiles test and platelet adhesion tests in vitro. It was found that all PU functionalized with zwitterionic brush showed improved resistance to nonspecific protein adsorption and platelet adhesion. (C) 2012 Elsevier B.V. All rights reserved.