Does anyone know the story behind the urokinase shortage? Anyone have any alternatives? Thanks in advance.

The FDA is the one that pulled the Uro open Cath due to safety QA issues with possible Bloodborne pathogens in to Uro. Uro is made from human tissue. At the ANNA meeting Abbott stated they were in the process of having their QA techniques verified as safe. They have a web site www.abbottrenalcare.com or toll free # is 800-457-9472 and you should be able to get copies of the info on the recall and update on the status.

I checked out the web site- go to www.abbottrenalcare.com Then look under Site Index go to Our Products then select Pharmaceutical Products. Click on Abbokinase and the April warning letter is posted. Hard to find on the site- a search under Uro doesn't bring up the warning. Looks like no new news on the issue.

Our Abbott rep said they are working on a synthetic UK as the FDA is not looking at releasing Uk in it's present form. What do you all do now that UK is not available? We have gone to have the radiologist strip the catheter. It's a lot more expensive and invasive.

I have heard of some clinics sending their patients to the hospital for treatment with TPA. I'm not sure exactly what TPA is but I understand it is expensive, comes in 250,000 unit dosages and can not be used in a free standing dialysis unit.
Some hospital based facilities are able to use it because they are in the hospital and their in-house pharmacy has divided the TPA 250,000 unit dose into many smaller single use doses and frozen them.

Anyone heard about this ?

I have also heard that Abbott is not going to bring the standard UK back but will be waiting until the recombinent form is ready.

Has anybody at the FDA thought to look at how many patients have lost their accesses and/or their lives as a result of this whole UK mess ? I don't believe there was ever a documented case of a patient becoming contaminated by tainted UK.

This whole mess makes no sense.

Lizzie,
Yes you are right the whole thing is a mess and sad for ESRD patients that need a vascular access as a lifeline. TPA was first used to break down coronary artery clots in patients with chest pain and early phases of a heart attach. It works well to break down the forming clot and restore blood supply to the heart and prevent long term damage. It is very expensive (but cheaper than treatment of a MI with angioplasty or bypass). The TPA has been used as you described in smaller doses, but this is an off label use of TPA.

Lot�s of rumors about the Uro- will have to just wait and see what happens.

I've seen ads for these roto-rooter devices that remove clots. When are they appropriate? What's the upside and downside to them?

Tom,
See other message area called Endoluminal Brush. That's all I know about the brush. Not sure if that is what you are seeing or not. The brush is for catheters.
The other devices are for AV graft declots. Scott Tretotla (from the DOQI work group) has a clot buster device made by Arrow (800-233-3187 or www.arrowintl.com) See DOQI Guideline # 21- "all forms of thrombolysis are effective for resolving thrombosis" that refers to surgical,mechanical or pharacomechanical thrombolysis. Cost is the major difference.

Also check out the new post by Gary under Dialysis Business World -Possis released new clot removing AngioJet and just click on it.