Dialyzer reuse: interaction between dialyzer membrane, disinfectant (formalin), and blood during dialyzer

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Y Y Ng1, A H Yang, K C Wong

  • 1Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China.

Artificial Organs
|January 1, 1996
PubMed

Insights

Dialyzer reuse may cause adverse reactions. Reprocessed membranes can shed denatured blood components, potentially triggering immune responses like anti-Nform antibody formation in patients undergoing hemodialysis.

Area of Science:

  • Biomaterials Science
  • Nephrology
  • Immunology

Background:

  • Dialyzer reuse is common for medical and economic reasons.
  • Adverse reactions, including immunohemolytic anemia linked to anti-Nform antibodies, have been reported with reused dialyzers.
  • Formaldehyde is a common disinfectant used in dialyzer reprocessing.

Purpose of the Study:

  • To investigate the interaction between blood components and reprocessed polysulfone dialyzer membranes.
  • To assess the adherence and potential detachment of blood components after formaldehyde disinfection.
  • To explore the implications for patient immune responses during hemodialysis.

Main Methods:

  • Scanning electron microscopy (SEM) to visualize membrane-blood component interactions.
  • Cytologic staining techniques for cellular analysis.
  • Sonication and simulated hemodialysis to test detachment of adhered components.

Main Results:

  • Various blood components, including fibrin and cells, adhered to the polysulfone membrane post-reprocessing.
  • Adhered, denatured blood components could be detached by sonication or simulated hemodialysis.
  • Detached components could re-enter the patient's circulation.

Conclusions:

  • Reprocessed dialyzers may retain and release denatured blood components.
  • The re-entry of these components could enhance immunological responses.
  • This may contribute to antibody formation, such as anti-Nform antibodies, in patients using reused hemodialyzers.

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