Residual Ethylene Oxide in Hollow‐Fiber Dialyzers

Henne, Werner; Dietrich, Wolfgang; Pelger, Michael; Sengbusch, G. von

doi:10.1111/j.1525-1594.1984.tb04295.x

Cited by 37 publications

(8 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Figure 9 summarizes some of the possible pathways to bioincompatibility which have been suggested from recent studies. Allergic reactions arising from sensitization to ethyl ene oxide are associated with the presence of IgE antibodies against conjugates of human serum albumin and residual ethylene oxide [128,129] present in dialyzer components, especially polyurethane potting materials used with hollow-fiber dialyzers [130], Bind ing of the antigen to IgE antibodies triggers mast cell activation, degranulation and se cretion of a variety of biologically active compounds, including histamine, arachidonic acid metabolites and platelet-activat ing factors.…”

Section: Biocompatibility In Renal Prosthesesmentioning

confidence: 99%

Analysis of Membrane Processes for Blood Purification

Colton

1987

Blood Purif

View full text Add to dashboard Cite

Physical phenomena play an important role in membrane processes for blood purification. They largely determine the separation performance of these devices and they interact with chemical and biological phenomena to determine their biocompatibility, or lack thereof, in the clinical setting. In the first part of this paper, analyses of physical phenomena which determine the separation and purification characteristics are reviewed for several processes, including hemodialysis, hemofiltration, combined hemodialysis and ultra-filtration, and membrane plasmapheresis with cross-flow microfiltration. Special attention is given to transport of high-molecular weight solutes in hemodialysis, for use in subsequent analyses, and to the factors which determine filtrate flux in membrane plasmapheresis, because recent findings in this area provide an understanding of filtration processes in general. The second part concerns the problem of biocompatibility, especially as manifested in renal prostheses. After reviewing some of the pathways to bioincompatibility, exploratory analyses are presented using relatively simple models. The objective of these analyses is to provide an initial quantitative framework for examining the likelihood of monocyte secretion of interleukin-1 being stimulated by various routes. Issues examined, for which illustrative calculations are presented, include (1) transport of endotoxin fragments across regenerated cellulose and other membranes, (2) anaphylatoxin C5a concentrations in conventional hemodialysis and (3) the effects of equilibrium and reaction phenomena, ultrafiltration, diffusive membrane permeation and membrane adsorption on the disposition of C5a which is generated at the membrane surface.

show abstract

Section: Biocompatibility In Renal Prosthesesmentioning

confidence: 99%

Analysis of Membrane Processes for Blood Purification

Colton

1987

Blood Purif

View full text Add to dashboard Cite

show abstract

“…Others are race, age, the immunological and hormonal status of the host (e.g., histamine releasability), and dose of the sensitogen received. The dose of ETO that dialysis patients are exposed to depends on dialyzer design [e.g., whether or not the dialyzer contains potting compound (18)(19)(20)(21)], the deaeration time of the device, and the rinsing procedure immediately before use.…”

Section: Discussionmentioning

confidence: 99%

Mediation of Hypersensitivity Reactions During Hemodialysis by IgE Antibodies Against Ethylene Oxide

Lemke¹

1987

Artificial Organs

View full text Add to dashboard Cite

Sera from 329 hemodialysis patients, 46 of whom had experienced a hypersensitivity-type reaction during hemodialysis, were screened by an enzyme-allergosorbent test (EAST) for IgE antibodies specific for ethylene oxide (ETO). In seven of nine patients who had experienced a severe hypersensitivity reaction (type II or type III), high titers of IgE antibodies against ETO (greater than 3.0 PRU/mL) were found. However, plasma levels of IgE specific for ETO were in the normal range (less than 0.35 PRU/mL) in most (30/37) patients who had experienced a mild (type I) reaction. Selected sera from patients who had experienced severe reactions were further examined for IgE directed against isopropyl myristate (IPM), 2-chloroethanol, and extracts from unsterilized dialyzers. Importantly elevated serum levels of specific IgE against these substances could not be documented. Extracts of an ETO-sterilized, hollow-fiber dialyzer were positive, whereas extracts of an ETO-sterilized dialyzer containing a flat membrane were negative in the EAST. This difference can be explained by the different amounts of ETO present in the dialyzers. We conclude that ETO causes most severe hypersensitivity reactions by an IgE-mediated mechanism. On the other hand, the pathogenesis of mild (type I) reactions is less clearly associated with ETO allergy. Our results also suggest that other potentially allergenic substances in dialyzers (e.g., IPM, 2-chloroethanol) rarely induce specific IgE antibodies in dialysis patients.

show abstract

“…However, contrary to a previous study [4], there was no clear difference between Ca and PAN equip ment. It may be suggested that this was due to the fact that the PAN filter included in this study was of the hollow-fiber type, hence exposing blood to potting material which can have detrimental effect on biocompatibility [13], but the in vitro incubations ( fig. 7) where only membrane material was used do not support this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Biocompatibility Aspects of Cellophane, Cellulose Acetate, Polyacrylonitrile, Polysulfone and Polycarbonate Hemodialyzers

Smeby¹,

Widerøe²,

Balstad³

et al. 1986

Blood Purif

View full text Add to dashboard Cite

The biocompatibility of cuprammonium rayon (Cu), cellulose acetate, polysulfone (Ps) and polyacrylonitrile hollow-fiber dialyzers and a polycarbonate-polyether flat plate dialyzer has been investigated. The Cu dialyzer resulted in more complement activation and a greater degree of leukopenia than the others, while the Ps hollow-fiber dialyzer appeared to be the most biocompatible of the membrane equipment in this study. These results were confirmed by in vitro evaluations and microscopic examinations of the different dialyzers.

show abstract

Residual Ethylene Oxide in Hollow‐Fiber Dialyzers

Cited by 37 publications

References 1 publication

Analysis of Membrane Processes for Blood Purification

Analysis of Membrane Processes for Blood Purification

Mediation of Hypersensitivity Reactions During Hemodialysis by IgE Antibodies Against Ethylene Oxide

Biocompatibility Aspects of Cellophane, Cellulose Acetate, Polyacrylonitrile, Polysulfone and Polycarbonate Hemodialyzers

Contact Info

Product

Resources

About