CHBT Reuse and Disinfection Protocols

Question 1

What is the primary justification for dialyzer reuse programs in hemodialysis?

Accepted Answer

Cost reduction and potential improvement in biocompatibility due to protein coating of the membrane reducing first-use syndrome

Answer

Reused dialyzers provide higher clearance than new dialyzers

Answer

Reuse is required by CMS as a cost-saving measure for ESRD programs

Answer

Reused dialyzers have a smaller priming volume, reducing patient blood loss

Question 2

Which test is performed to determine if a reused dialyzer is still suitable for patient use?

Accepted Answer

Total cell volume (TCV) test to verify at least 80% of original fiber bundle volume is maintained

Answer

Culture of the dialyzer interior for bacterial growth

Answer

Weighing the dialyzer to confirm it has not gained mass from protein accumulation

Answer

Visual inspection only; no laboratory testing is required

Question 3

What is the most commonly used disinfectant for dialyzer reprocessing in the United States?

Accepted Answer

Peracetic acid/hydrogen peroxide mixture (e.g., Renalin)

Answer

Formaldehyde (37% solution)

Answer

Glutaraldehyde

Answer

Sodium hypochlorite (household bleach)

Question 4

Before a reprocessed dialyzer is returned to a patient, what must be verified to ensure patient safety?

Accepted Answer

Residual disinfectant must be tested and confirmed below safe threshold levels before connecting to the patient

Answer

The dialyzer should be refrigerated for at least 12 hours before reuse

Answer

The disinfectant fill must remain in the dialyzer until connected to the blood circuit

Answer

Visual clarity of the dialyzer housing confirms adequate disinfection without chemical testing

Question 5

What information must be labeled on a reprocessed dialyzer?

Accepted Answer

Patient name/ID, number of previous uses, date of last reprocessing, and disinfectant used

Answer

Only the patient's name and room number

Answer

The dialyzer serial number and manufacturing date only

Answer

The technician's name and the machine it will be used on

Question 6

Under AAMI guidelines, what is the maximum number of times a dialyzer can be reused before mandatory discard?

Accepted Answer

There is no universal maximum; reuse continues as long as the dialyzer passes TCV and integrity testing at each reprocessing

Answer

A maximum of 10 uses for all dialyzers regardless of performance

Answer

A maximum of 3 uses for high-flux dialyzers and 5 for low-flux

Answer

25 uses for automated reprocessing systems and 10 for manual