American Samoa's only dialysis clinic has reopened after a product recall forced it to close for two days.

LBJ Medical Center said the clinic reopened at 4 p.m. Friday and began treating patients who require dialysis. The clinic shut down Wednesday after the hospital learned of a recall of a solution used in its machines. A fresh supply arrived to the island around 2 p.m. Friday. The clinic had been scheduled to reopen at 1 a.m. Saturday.

Those being treated Friday to Sunday are patients who had appointments scheduled for Wednesday through Saturday. Regularly scheduled appointments are expected to resume Monday.

"Those who came in say that they knew that the cargo flight had landed and decided to come to the hospital — taking their chances that the clinic will open thereafter," said dialysis unit nurse manager Olita Tafiti. "I guess word got out quickly that the shipment did in fact arrive on island."

Tafiti said three dialysis patients admitted themselves to the emergency room early Friday afternoon, and they were the first to get treatment when the clinic opened.

Until Friday, there were no other options for dialysis patients on the island with a population of about 55,000, roughly 2,300 miles south of Hawaii.

The recalled solution was from off-island supplier Fresenius Medical Care. Its North American headquarters is in Waltham, Massachusetts.

The recall occurred after sample testing showed the substance — NaturaLyte Liquid Bicarbonate Concentrate — might eventually develop bacteria levels that exceed acceptable limits, Fresenius spokesman Jon Stone said.

The company expedited the shipment of replacement liquid bicarbonate to American Samoa, Stone said.

How long a patient can safely go without dialysis depends on factors such as health condition and age, said Dr. Anjay Rastogi, director the dialysis program at the University of California, Los Angeles.

Generally, patients require the treatment three times a week, with some cases requiring four treatments, Rastogi said. Some patients can go a week without dialysis, but some with no kidney function can go only three or four days, he said.

"The short end of it, it's very time-sensitive," Rastogi said, adding he's especially concerned about those who might not have had dialysis since Monday.

He noted any contamination in the solution used for dialysis could be fatal.

Another shipment is due to arrive Friday night from Honolulu on Hawaiian Airlines, the only carrier connecting American Samoa to the U.S.

Additionally, a U.S. military flight is scheduled to arrive Monday afternoon from Honolulu with the rest of the supplies, Tafiti said.

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Associated Press writer Jennifer Sinco Kelleher in Honolulu contributed to this report.

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