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Plate, Coil, and Hollow‐Fiber Cuprammonium Cellulose Dialyzers: Discrepancy Between Incidence of Anaphylactic Reactions and Degree of Complement Activation
Author(s) -
Daugirdas John T.,
Potempa Leonard D.,
Dinh Ngoclan,
Gandhi Vasant C.,
Ivanovich Peter T.,
Ing Todd S.
Publication year - 1987
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1987.tb02646.x
Subject(s) - chemistry , cellulose , complement system , dialysis , fiber , chromatography , immunology , medicine , biochemistry , surgery , antibody , organic chemistry
During the past 10 years, the incidence of severe anaphylactic reactions during dialysis [type A first‐use syndrome (FUS)] at our center has been much lower when using cuprammonium cellulose plate (CC‐P) dialyzers (0/37,750 dialyses) or coil (CC‐C) dialyzers (0/32,500) than when using cuprammonium cellulose hollow‐fiber (CC‐F) dialyzers (8/21,022 dialyses, p < 0.005 by Chi‐square). To determine if the difference in type A FUS incidence between the three dialyzer types could be explained by differences in complement activation, we compared plasma concentrations of C3a des‐arginine (des arg) in patients undergoing dialysis with these three varieties of dialyzers. Plasma C3a des arg values increased markedly in the dialyzer outflow blood with the three dialyzer configurations. The levels were similar with the dialyzer types when results were corrected for membrane surface area. Also, the degree of leukopenia was not markedly different with the three dialyzer types. Our findings suggest that complement activation per unit surface area is similar during dialysis with plate, coil, and hollow‐fiber cuprammonium cellulose dialyzers. The lack of correlation between the degree of complement activation and the incidence of type A FUS suggests that membrane‐induced complement activation is not of primary importance to type A dialyzer hypersensitivity reactions.