By Norman Deane

The objective of this publication is to supply details for the nephrologist to achieve a viewpoint at the scientific, medical, and technical points of reprocess­ ing of hemodialyzers. The e-book is usually designed to serve the desires of the linked scientific, nursing, and technical staffs of dialysis amenities for information on reuse of hemodialyzers. As a knowledge resource, the e-book will end up to be precious if you happen to could be contemplating reprocessing of dialyzers, in addition to individuals who're presently fascinated about this element of the perform of nephrology. we now have all for the medical and technological facets of hemodialyzer reprocessing and feature now not handled socioeconomic concerns. We do desire to percentage with physicians appearing hemodialysis numerous observations we've made due to assembling this quantity. We think that hemodialyzer reuse has had a precious effect at the caliber of deal with hemodialysis sufferers in attention of the subsequent elements. there's an elevated wisdom of membrane biocompatibility matters that has been dropped at the leading edge with the appliance of reuse. usage ofhemodialyzer reprocess­ ing has enabled nephrologists . to match the impression of varied measures on biocompatibility while the sufferer is uncovered to both a brand new or a reprocessed equipment. formerly, few on hand comparisons existed. within the perform of dialysis, water caliber has consistently been of substantial value. With the appearance of common hemodialyzer reprocessing, the problems of water bacteriology and water caliber became extra prominent.

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Deane and Bemis [4] measured particulates eluting from new and multiply used CUPROPHAN® dialyzers, and found no significant difference. Keshaviah et al. [5, 69] also have reported particulate levels. CONCLUSIONS Those procedural steps that seem to be the most important for improving the reprocessing of hemodialyzers and hemofilters are the following: 1. Prompt reprocessing after use. 2. Thorough removal of air bubbles from the blood compartment during rinsing, possibly to include degassing the blood compartment prior to filling the blood compartment with sterilant.

Rinse blood compartment until clear (10-40 min) and then nnse the dialysate compartment with H 2 0 at 70 mmHg. 2. Apply reverse ultrafiltration (50 mmHg on dialysate side). 3. 0% sodium hypochlorite (NaOCI) for 1 min. 4. 0% HCHO. 5. Prepare for use with a 30-min flush of the dialysate compartment and then rinse the blood compartment with 500 ml saline. 3% NaOCI, Kaye et al. [21] were able to obtain, on the average, 16 reuses of the Gambro 120M dialyzer. nd phosphate in up to 30 uses. Bourke et al.

7. Stroncek DF, Keshaviah P, Craddock PR, Hammerschmidt DE: Effect of dialyzer reuse on complement activation and neutropenia in hemodialysis. J Lab Clin Med 104:304-311, 1984. 8. Deane N, Wineman RJ: Comparative evaluation of automated devices for reprocessing hemodialyzers: intradialytic patient response. Trans Am Soc Artif Intern Organs 30:498-501, 1984. 9. Jayashankar ]E, Karfonta S, Venkatachalam K, Deegan MJ: Effect of method of dialyzer reprocessing on complement activation, leucopenia, and symptoms during hemodialysis: a randomized controlled study [abstr}.

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