Haemolysis due to formaldehyde-induced anti-N-like antibodies in haemodialysis patients.
During reuse of formaldehyde sterilized Kiil-dialysers, red cell survival, measured by means of 51Cr t/2, was significantly reduced (p less than 0.001) in 16 patients with anti-N-like positive sera, when compared with 19 antibody negative control patients (mean +/- SD: 16.5 +/- 2.7 versus 22.4 +/- 3.1 days.) In antibody negative patients (n = 10) replacement of formaldehyde sterilized dialysers by ethylene-oxide sterilized disposable dialysers resulted in a significant increase (p less than 0.002) of 51Cr t/2 (Mean +/- SD, days: Kiildialyser 16.3 +/- 1.9; disposable dialyser 20.3 +/- 3.5). This improvement took place, although antibody titres persisted during the 51Cr-measurements and declined thereafter only slowly. In antibody negative patients (n = 6) red cell survival did not increase, when formaldehyde as a sterilant was avoided. In antibody positive patients mean haematocrit rose significantly (p less than 0.05), whereas in none of the antibody negative patients a definite change of haematocrit occurred. The data demonstrate, that formaldehyde sterilisation of dialysers may cause antibody-mediated haemolysis contributing to the extent of renal anaemia. This immunohaemolysis may be corrected, in spite of continuing antibody persistance, when formaldehyde exposure is totally avoided, or possibly when minimized.
D000917:Antibody Formation / Q000187:drug effects*; D005027:Ethylene Oxide / Q000494:pharmacology; D005557:Formaldehyde / Q000494:pharmacology*; D006400:Hematocrit; D006461:Hemolysis; D006801:Humans; D007688:Kidneys, Artificial; D008951:MNSs Blood-Group System / Q000276:immunology*; D006435:Renal Dialysis; D013242:Sterilization
D008951:MNSs Blood-Group System; D005557:Formaldehyde; D005027:Ethylene Oxide