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A porcine model of hemodialyzer reactions: roles of complement activation and rinsing back of extracorporeal blood

Permanent lenke
https://hdl.handle.net/10037/23751
DOI
https://doi.org/10.1080/0886022X.2021.2007127
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article.pdf (2.581Mb)
Publisert versjon (PDF)
Dato
2021-12-09
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Forfatter
Pethő, Ákos; Piecha, Dorothea; Mészáros, Tamás; Urbanics, Rudolf; Moore, Christoph; Canaud, Bernard; Mollnes, Tom Eirik; Steppan, Sonja; Szénási, Gábor; Szebeni, János; Dézsi, László
Sammendrag
Hemodialysis reactions (HDRs) resemble complement-activation-related pseudoallergy (CARPA) to certain i.v. drugs, for which pigs provide a sensitive model. On this basis, to better understand the mechanism of human HDRs, we subjected pigs to hemodialysis using polysulfone (FX CorDiax 40, Fresenius) or cellulose triacetate (SureFlux-15UX, Nipro) dialyzers, or Dialysis exchange-set without membranes, as control. Experimental endpoints included typical biomarkers of porcine CARPA; pulmonary arterial pressure (PAP), blood cell counts, plasma sC5b-9 and thromboxane-B2 levels. Hemodialysis (60 min) was followed by reinfusion of extracorporeal blood into the circulation, and finally, an intravenous bolus injection of the complement activator zymosan. The data indicated low-extent steady rise of sC5b-9 along with transient leukopenia, secondary leukocytosis and thrombocytopenia in the two dialyzer groups, consistent with moderate complement activation. Surprisingly, small changes in baseline PAP and plasma thromboxane-B2 levels during hemodialysis switched into 30%–70% sharp rises in all three groups resulting in synchronous spikes within minutes after blood reinfusion. These observations suggest limited complement activation by dialyzer membranes, on which a membrane-independent second immune stimulus was superimposed, and caused pathophysiological changes also characteristic of HDRs. Thus, the porcine CARPA model raises the hypothesis that a second “hit” on anaphylatoxin-sensitized immune cells may be a key contributor to HDRs.
Forlag
Taylor & Francis
Sitering
Pethő, Piecha, Mészáros, Urbanics, Moore, Canaud, Rosivall, Mollnes, Steppan, Szénási, Szebeni, Dézsi. A porcine model of hemodialyzer reactions: roles of complement activation and rinsing back of extracorporeal blood. Renal failure. 2021;43(1):1609-1620
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  • Artikler, rapporter og annet (klinisk medisin) [1974]
Copyright 2021 The Author(s)

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