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Dialyzer reprocessing: Considerations and pitfalls for effective and safe hemodialysis
Thana Thongsricome1,2, Somchai Eiam-Ong1, Khajohn Tiranathanagul1
1Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Seminars in Dialysis
|June 15, 2023
Summary
Dialyzer reprocessing offers a cost-effective hemodialysis option. Strict adherence to protocols ensures safety, though evidence on mortality benefits remains mixed compared to single-use strategies.
Area of Science:
- Nephrology
- Biomedical Engineering
- Public Health
Background:
- Dialyzer reprocessing for hemodialysis reuse has historical roots in cost and time savings.
- This practice can mitigate first-use and allergic reactions associated with cellulosic dialyzer membranes.
Purpose of the Study:
- To review and summarize recent dialyzer reprocessing methods and considerations.
- To compare dialyzer reuse with single-use strategies in hemodialysis.
Main Methods:
- Extensive literature review of established studies on dialyzer reprocessing.
- Synthesis of information on protocols, safety considerations, and environmental impact.
Main Results:
- Reprocessing involves rinsing, cleaning, testing, disinfection/sterilization, storage, and final rinsing.
- Conflicting evidence exists regarding mortality outcomes; peracetic acid sterilization has been linked to increased mortality.
- Effective reuse requires adherence to manufacturer protocols, quality dialysis water, total cell volume measurement, and infection control.
Conclusions:
- Dialyzer reprocessing is an acceptable, cost-effective hemodialysis option when properly regulated.
- Environmental impacts of both reprocessing (liquid waste) and single-use (solid waste) require consideration.
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