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March 1985

Severe Anaphylactoid Reactions to Cuprammonium Cellulose Hemodialyzers

Author Affiliations

From the Departments of Medicine, Hines-Loyola Medical Center, Hines, Ill (Drs Daugirdas, Ing, and Popli) and Northwestern University School of Medicine, Chicago (Drs Roxe, Ivanovich, and Krumlovsky, and Ms McLaughlin).

Arch Intern Med. 1985;145(3):489-494. doi:10.1001/archinte.1985.00360030137024

• Twenty-one severe reactions to hemodialysis occurred in approximately 260,000 dialysis treatments at three centers within a 10½-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.

(Arch Intern Med 1985;145:489-494)