K. Opatrny et al., A CLINICAL-STUDY TO ASSESS THE EFFECT OF HEPARIN IN DIALYZER RINSING SOLUTIONS, International journal of artificial organs, 20(2), 1997, pp. 112-118
The solution usually recommended for rinsing the blood side, which is
an indispensable step in preparing a dialyzer for hemodialysis (HD), c
ontains saline and heparin. The heparin used for rinsing is said to re
duce the thrombogenic properties of the dialysis membrane and, hence,
also the need for systemic heparinization during the whole procedure.
The aim of our study was to establish whether this postulate also appl
ies to polysulphone steam-sterilized dialyzers. To do so, 16 patients
on long-term dialysis were randomized into two groups of eight One gro
up was subsequently treated with polysulphone low-flux dialyzers (FGHP
S), the other with polysulphone high-flux dialyzers (F6OS). Both group
s were examined, in a crossover manner during HD using a dialyzer prev
iously rinsed with 1000 mi of saline plus 2,000 IU of heparin, and dur
ing HD using a dialyzer previously rinsed with 500 mi of saline withou
t heparin. Except for the rinsing, HD conditions were completely ident
ical. Blood obtained before HD, and at 15, 60 and 240 min of HD at the
dialyzer inlet, was used to determine the activated partial thrombopl
astin time (to test heparinization control), the thrombin-antithrombin
III complex (ELISA, to evaluate coagulation system activation), plate
let factor 4 (ELISA, a substance with antiheparin activity), and plate
let count. None of the above parameters showed, at any of the collecti
ng intervals, a statistically significant difference between HD with a
nd without heparin with a reduced volume of rinsing solution, or betwe
en HD using low- and high-flux dialyzers. ii is concluded that heparin
used to rinse polysulphone dialyzers before HD has no effect on blood
coagulation or on the need for heparin during the procedure.