IgE against ethylene oxide-altered human serum albumin in patients who have had acute dialysis reactions.

Serum samples obtained from seven hemodialysis patients with immediate-type allergic reactions, from six hemodialysis patients without reactions, and from three nonatopic control subjects were analyzed for IgE against human serum albumin exposed to ethylene oxide (ETO-HSA). ETO is used to sterilize medical equipment like dialyzers that cannot withstand heat sterilization. IgE to ETO-HSA, measured by a polystyrene tube technique was found in six of seven dialysis reactor patients but in only one of six nonreactor patients (p less than 0.05 two-tailed Fisher's exact test). No control sera from three nonatopic individuals had antibody. The reactor patients had 2.0 +/- 8.0 ng (SD) of ETO-HSA bound per milliliter of serum, whereas nonreactor patients had 0.2 +/- 8.0 ng per milliliter bound (p less than 0.05 one-tailed Student's t test on log transformed values). We suggest that there is an association between the presence of IgE to ETO-HSA and immediate-type allergic reactions to dialysis in this group of patients.