HEMOLYSIS DUE TO FORMALDEHYDE-INDUCED ANTI-N-LIKE ANTIBODIES IN HEMODIALYSIS-PATIENTS

During reuse of formaldehyde sterilized Kiil-dialysers, red cell survival, measured by means of51Cr t/2, was significantly reduced (p<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 form-aldehyde sterilized dialysers by ethylene-oxide sterilized disposable dialysers resulted in a significant increase (p<0.002) of51Cr t/2 (Mean±SD, days: Kiil-dialyser 16.3±1.9; disposable dialyser 20.3±3.5). This improvement took place, although antibody titres persisted during the51Cr-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<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. © 1979 Springer-Verlag.