Ethylene Oxide Sensitivity in Hemodialysis Patients

Abstract

Sera from 138 patients who had experienced hypersensitivity‐type reactions while on hemodialysis (reactors) were examined retrospectively by the radioal‐lergosorbent test (RAST) for specific IgE antibody to ethylene oxide (ETO). Seventy‐eight hemodialysis patients without a history of reaction were also evaluated as controls. Elevated serum RAST values (> 2.0) were more common in reactors (63%) than in controls (11%, p < 0.001). In a second study, RAST assays were performed using human serum albumin conjugated to ETO (HSA‐ETO) as antigen and also using a concentrate of fluid used to rinse ETO‐sterilized dialyzers (“dialyzer extract”) as antigen. The RAST ratios obtained with HSA‐ETO were similar to those obtained using the dialyzer extract (rank order correlation coefficient = 0.829, p < 0.001). In a third study, RAST inhibition was demonstrated both by HSA‐ETO and dialyzer extract. Our results, extending previously published reports, suggest that hypersensitivity to ETO might play an important role in hemodialysis‐associated hypersensitivity‐type reactions.