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dc.contributor.authorPethő, Ákos
dc.contributor.authorPiecha, Dorothea
dc.contributor.authorMészáros, Tamás
dc.contributor.authorUrbanics, Rudolf
dc.contributor.authorMoore, Christoph
dc.contributor.authorCanaud, Bernard
dc.contributor.authorMollnes, Tom Eirik
dc.contributor.authorSteppan, Sonja
dc.contributor.authorSzénási, Gábor
dc.contributor.authorSzebeni, János
dc.contributor.authorDézsi, László
dc.date.accessioned2022-01-21T12:57:18Z
dc.date.available2022-01-21T12:57:18Z
dc.date.issued2021-12-09
dc.description.abstractHemodialysis 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.en_US
dc.identifier.citationPethő, 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):1609-1620en_US
dc.identifier.cristinIDFRIDAID 1973928
dc.identifier.doi10.1080/0886022X.2021.2007127
dc.identifier.issn0886-022X
dc.identifier.issn1525-6049
dc.identifier.urihttps://hdl.handle.net/10037/23751
dc.language.isoengen_US
dc.publisherTaylor & Francisen_US
dc.relation.journalRenal failure
dc.relation.projectIDinfo:eu-repo/grantAgreement/RCN/SFF/223255/Norway/Centre of Molecular Inflammation Research/CEMIR/en_US
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/H2020-EU.3.1.3./825825/Italy/Centre of Molecular Inflammation Research/UPGRADE/en_US
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/H2020-EU.4.b./952520/Hungary/Biosafety assays for the diagnosis and prediction of drug-related complement pathology/Biosafety/en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.titleA porcine model of hemodialyzer reactions: roles of complement activation and rinsing back of extracorporeal blooden_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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