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Abstract: PO0932

Feasibility of Allo-Hemodialysis: First Experience from Porcine Studies

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Wang, Xin, Renal Research Institute, New York, New York, United States
  • Patel, Amrish U., Renal Research Institute, New York, New York, United States
  • Gothi, Anil Kalidas, Vivo Bio Tech Ltd, Hyderabad, India
  • Nikolic, Dejan, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
  • Heide, Alexander, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
  • Dong, Jiaming, Fresenius Medical Care Shanghai Co Ltd, Shanghai, Shanghai, China
  • Zhang, Hao, Fresenius Medical Care Shanghai Co Ltd, Shanghai, Shanghai, China
  • Maheshwari, Vaibhav, Renal Research Institute, New York, New York, United States
  • Grobe, Nadja, Renal Research Institute, New York, New York, United States
  • Nayak, K s, Virinchi Hospitals, Hyderabad, Telangana, India
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background

Annually, millions of kidney patients, predominantly in low and low-middle income countries, die prematurely because of unavailability of affordable kidney replacement therapy. We previously demonstrated through mathematical modeling and bench testing the feasibility of alloHD, an alternative low-cost hemodialysis treatment approach where the blood of a kidney failure patient flows counter-current to that of a healthy subject (“buddy”) through a dialyzer. Herein we report first results from an alloHD feasibility study in a porcine model. We aimed to specifically address questions around hemolysis and coagulation of the dialysate compartment.

Methods

Ethics protocol was approved by Committee for the Purpose of Control and Supervision of Experiments on Animals, India. Under general anesthesia, healthy female white Yorkshire pigs of 30 to 80 kg with central venous catheter as vascular access were dialyzed 1-3x weekly for 2-4 hours. Ultrafiltration volume goals were set between 0 and 1000 mL. “Patient” and “buddy” pigs were connected to the dialysate and blood compartments, respectively, of a Nipro Cellentia 17H (Fig. 1). Pigs were anticoagulated with 5000 IU heparin per hour. Pre- and post-treatment blood samples were collected for biochemical measurements.

Results

We successfully completed 10 alloHD sessions. No coagulation was observed. Visual inspection of plasma samples indicated no signs of hemolysis. This was further corroborated by measurements of lactate dehydrogenase and haptoglobin, which were available in seven experiments (Fig. 2).

Conclusion

We found no indication of hemolysis and dialysate compartment coagulation in our experiments. Upcoming studies in a porcine renal failure model will address in vivo solute clearances by alloHD.

Funding

  • Commercial Support