Publisher Summary During test runs with a new Danish haemodialysis monitoring system in three patients it has been observed that the patients exhibited abdominal distress the intensity of which increased with the length of the treatment and the number of consecutive dialysis runs. The chapter discusses this phenomenon. Liver function tests were found to be increasingly abnormal with overt jaundice in one case. The symptoms disappeared on returning to the equipment ordinarily used in the unit, only to return on the resumption of the test runs. As the monitor is found normal, the new PVC-tubings are submitted to perfusion experiments with subsequent analysis of the perfusates for their content of plasticizers. The infrared and proton magnetic resonance spectra unequivocally disclosed the leakage of diethylphthalate from the new PVC tubings, a substance the presence of which is not demonstrated in the perfusates from a series of commercially available dialysis tubings. The chapter describes the methods used and the results of a series of investigations aimed at clarifying the release of this abnormal constituent of the PVC tubings.

Prompted by a series of hepatitis-like cases in patients on regular haemodialysis treatment, the sets of polyvinylchloride (PVC) test tubings used were submitted to perfusion experiments. The perfusates from four commercially available tubings were also investigated. Diethylphthalate (DEP) could be identified by by IR and PMR spectrometry in the perfusate from the test tubings. UV spectrometry proved the presence of other non-identified substances in the perfusate from both the test tubings and from some of the other tubings.

In a four-year period three isolated cases of hepatitis were observed within a period of 2 months in a haemodialysis unit. The cases occurred in 3 patients during testing of new haemodialysis equipment. Liver biopsy in 2 patients showed non-specific hepatitis and changes as in “viral hepatitis” respectively. From the tested blood tubings, manufactured from polyvinylchloride (P.V.C.), diaethylphthalate was washed out in an amount of 10–20 mg per litre aqueous perfusate. From the tubings normally used in the department this compound was not released on perfusion, and the symptoms disappeared rapidly when treatment with the use of these tubings was resumed.