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Dialyzer First Use Reaction with Polysulfone Membrane: Moving Beyond Ethylene Oxide
1Department of Nephrology, SH Medical Centre, Kottayam, Kerala, India.
Indian Journal of Nephrology
|September 29, 2021
Summary
Acute anaphylactic reactions to dialyzers are uncommon but may persist. Two cases with polysulfone dialyzers suggest reactions may stem from the membrane material or leachables, not sterilization methods.
Area of Science:
- Nephrology
- Clinical Immunology
Background:
- Acute anaphylactic/anaphylactoid reactions to dialyzers are considered uncommon.
- Incidence was thought to decrease with biocompatible membranes and ethylene oxide-free sterilization.
- Recent studies suggest the incidence may remain unchanged.
Observation:
- Two cases of first-use dialyzer reactions occurred with polysulfone dialyzers.
- These dialyzers were not sterilized using ethylene oxide.
- Reactions were less severe or absent upon subsequent reuses.
Findings:
- The reactions occurred with polysulfone dialyzers, not sterilized by ethylene oxide.
- Reactions diminished with dialyzer reuse.
- Patients tolerated cellulose triacetate or pre-processed polysulfone dialyzers.
Implications:
- The cause of these reactions may be the polysulfone membrane itself or leachable substances.
- Further investigation into dialyzer materials and processing is warranted.
- Alternative dialyzer choices can successfully manage these reactions.
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