Dialyzer reprocessing

Abstract

The practice of reprocessing and reusing hemodialyzers can be traced to the very origins of chronic hemodialysis. The basic process associated with the reuse of hemodialyzers remains the same after over 50 years of practice: upon completion of a dialysis treatment the used dialyzer is cleaned, tested for efficacy and integrity, high-level disinfected or sterilized, and stored in a controlled environment for subsequent use. Reprocessing can be performed manually or by automated reprocessing systems. Automated systems provide control and consistency to the process. Chemical cleaning agents associated with dialyzer reprocessing include bleach, hydrogen peroxide and peracetic acid. Commonly used chemical disinfectants and sterilants include formaldehyde, and peracetic acid. A processing substituting heated citric acid for chemical germicides has been used on a limited basis. Advantages associated with dialyzer reuse include economic, efficacy and environmental returns while disadvantages include possible increased infections, exposure to chemical agents, development of antibodies and changes in dialyzer performance. Current controversies associated with dialyzer reuse are linked to studies documenting switching from reusing dialyzers to using disposable dialyzers by a single provider in the United States. The future of dialyzer reprocessing is linked to the same economic factors that initially promoted the practice. © 2013 Springer-Verlag Berlin Heidelberg.