Combined HA-330 Hemoadsorption and Hemodiafiltration in a Kidney Transplant Recipient with Catheter-Related Bloodstream Sepsis and Intracardiac Thrombosis: A Case Report

Introduction: Catheter-related bloodstream infections remain a major cause of morbidity in patients receiving maintenance dialysis. Management becomes particularly challenging in kidney transplant recipients with failed allografts because of persistent immunosuppression, severe systemic inflammation, and a high risk of thrombotic complications. Hemoadsorption has emerged as a promising adjunctive extracorporeal therapy for sepsis by reducing circulating inflammatory mediators. We present a case of successful integration of HA-330 hemoadsorption into the treatment of severe catheter-related sepsis in a patient with end-stage kidney disease.
Case Presentation: A 28-year-old woman with kidney failure secondary to glomerular disease underwent living-donor kidney transplantation in 2014. Following allograft rejection in 2024, she resumed maintenance hemodialysis. She was admitted with fever, weakness, chest pain, and signs of systemic infection. Blood cultures obtained from peripheral blood and the dialysis catheter grew Staphylococcus haemolyticus. Diagnostic evaluation revealed catheter-related sepsis, a fixed right atrial thrombus, bilateral pneumonia, severe anemia, and end-stage kidney disease requiring renal replacement therapy.
The patient received broad-spectrum antimicrobial treatment, anticoagulation, blood transfusions, and extracorporeal support. Two sessions of HA-330 hemoadsorption were performed in combination with hemodiafiltration
A marked reduction in inflammatory biomarkers was observed during treatment. C-reactive protein decreased from 335.1 to 28.7 mg/L (91% reduction), procalcitonin from 98.2 to 1.48 ng/mL (98.5% reduction). Leukocyte count decreased from 18.4×10⁹/L to 8.6×10⁹/L (Table №1). Follow-up echocardiography demonstrated a reduction of the right atrial thrombus from 30×14 mm to 16×11 mm. Repeat blood cultures were sterile, and the patient showed significant clinical improvement with resolution of systemic inflammatory manifestations.
The patient was discharged in stable condition for continuation of maintenance hemodialysis.
Conclusion: This case demonstrates the potential value of HA-330 hemoadsorption as an adjunct to standard therapy in severe catheter-related sepsis among dialysis patients with failed kidney transplants. Combined hemoadsorption and hemodiafiltration may contribute to clinical stabilization and recovery in complex septic conditions, warranting further investigation in larger patient cohorts.

Sepsis Hemoadsorption HA330 Hemodiafiltration CRBSI

Baigalym Z, Zhunusov A, Bakhtybaev E, Shpak S. Combined HA-330 Hemoadsorption and Hemodiafiltration in a Kidney Transplant Recipient with Catheter-Related Bloodstream Sepsis and Intracardiac Thrombosis: A Case Report. Central Asian Journal of Nephrology. 2026;2(2, Suppl. 1):cajn_A30. https://doi.org/10.63946/cajn/19535