Filiopoulos Vassilis, Manolios Nikolaos, Vlassopoulos Dimosthenis
Department of Nephrology, Amalia Fleming General Hospital, 15127 Athens, Greece.
Int J Artif Organs. 2013 Mar;36(3):217-9. doi: 10.5301/IJAO.5000186. Epub 2013 Feb 14.
Significant thrombocytopenia following hemodialysis with electron-beam (e-beam) sterilized membranes has been recently reported in a large-scale Canadian study. However, the underlying mechanism and the clinical significance of this finding remain undetermined as yet. We prospectively evaluated for a 4-month period the thrombocytopenic effect of the e-beam sterilized dialyzers as compared to the steam sterilized ones in two groups of well-controlled hemodialysis patients. There were no significant differences in pre- and post-dialysis platelet counts of patients using e-beam-sterilized dialyzers compared to those using steam-sterilized ones. Furthermore, no statistically significant differences between pre- and post-dialysis platelet counts were found throughout the study in the e-beam-sterilized group. However, 1 out of 9 patients demonstrated significant post-dialysis thrombocytopenia in 2/4 measurements. In conclusion, our study data do not support a continuously occurring thrombocytopenic effect in patients dialyzed with e-beam sterilized membranes. Further studies are needed to determine whether and how the use of e-beam sterilization may impact the interaction between certain membranes and platelets.
最近在一项大规模加拿大研究中报告了使用电子束(e-beam)灭菌膜进行血液透析后出现显著血小板减少症。然而,这一发现的潜在机制和临床意义尚未确定。我们前瞻性地评估了两组病情控制良好的血液透析患者,为期4个月,比较了电子束灭菌透析器与蒸汽灭菌透析器对血小板减少的影响。与使用蒸汽灭菌透析器的患者相比,使用电子束灭菌透析器的患者透析前和透析后的血小板计数没有显著差异。此外,在整个研究过程中,电子束灭菌组透析前和透析后的血小板计数之间没有发现统计学上的显著差异。然而,9名患者中有1名在2/4次测量中出现了显著的透析后血小板减少症。总之,我们的研究数据不支持使用电子束灭菌膜进行透析的患者持续出现血小板减少效应。需要进一步研究以确定电子束灭菌的使用是否以及如何影响某些膜与血小板之间的相互作用。