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White thrombus formation in blood tubing lines in a chronic hemodialysis unit

Suzanne Watnick1, Michael Stooksbury, Rolf Winter

  • 1P3 NEPH, Medical Director, Dialysis Unit, PVAMC, 3710 SW US Veterans Hospital Road, Portland, OR 97239, USA. watnicks@ohsu.edu

Clinical Journal of the American Society of Nephrology : CJASN
|January 11, 2008
PubMed
Abstract

Insights

White thrombus unexpectedly formed in hemodialysis blood tubing for 62% of patients. This issue, linked to specific tubing, was resolved by removing the implicated product, ensuring patient safety.

Area of Science:

  • Nephrology
  • Hematology
  • Medical Device Science

Background:

  • White particulate matter in banked blood components is documented.
  • No prior reports detailed white matter in blood tubing during hemodialysis.

Purpose of the Study:

  • To describe events, investigations, and conclusions of spontaneous white thrombus formation in hemodialysis blood lines.
  • To identify potential causes and contributing factors.

Main Methods:

  • Observational study at a hemodialysis unit (Oct 2006-Apr 2007).
  • Collected 68 variables on 34 chronic hemodialysis outpatients.
  • Microscopic and biochemical analyses of the white precipitate.

Main Results:

  • 62% of patients (21/34) developed white precipitate in blood tubing over 5 weeks.
  • Microscopic and biochemical analyses identified the precipitate as white thrombus (platelets and fibrin).
  • Similar findings were reported by other centers and resolved by removing specific tubing.

Conclusions:

  • Both patient-specific and tubing-specific factors likely contributed to thrombus formation.
  • Patient safety was not compromised.
  • Further assessment of clinical and manufacturing variables affecting platelet activation is recommended.

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