Severe anaphylactoid reactions to cuprammonium cellulose hemodialyzers.
Twenty-one severe reactions to hemodialysis occurred in approximately 260,000 dialysis treatments at three centers within a 10 1/2-year period. Reactions typically appeared within minutes of initiating dialysis, and were characterized by cardiopulmonary, mucocutaneous, and/or gastrointestinal tract symptoms highly suggestive of anaphylaxis. Four respiratory arrests and one death resulted. Analysis of dialyzer use patterns and of each patient's dialyzer exposure history strongly implicated hollow-fiber dialyzers made of cuprammonium cellulose (CC) as a cause of these reactions. No obvious factors could be found to identify predisposed patients. Less than optimal rinsing of the CC hollow-fiber dialyzers prior to use may have been responsible for some, but not all, of these reactions.
D000707:Anaphylaxis / Q000209:etiology* / Q000503:physiopathology; D002482:Cellulose / Q000009:adverse effects / Q000031:analogs & derivatives*; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000503:physiopathology; D006331:Heart Diseases / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008567:Membranes, Artificial; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D012120:Respiration Disorders / Q000209:etiology / Q000503:physiopathology; D012871:Skin Diseases / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors
D008567:Membranes, Artificial; D002482:Cellulose; C009865:cuprammonium cellulose