Vascular access devices used during harvest of peripheral blood stem cells : high complication rate in patients with a long-term dialysis central venous catheter

• Published in: Bone marrow transplantation (Basingstoke) Vol. 24; no. 7; pp. 793 - 797
• Main Authors: JOHANSSON, E, HANSSON, M, NILSSON, A. S, ENGERVALL, P
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.10.1999
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Categories; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - methods; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - methods; Catheters; Complications; Dialysis; Female; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic stem cells; Humans; Leukapheresis; Male; Medical instruments; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Patients; Peripheral blood; Renal Dialysis - adverse effects; Renal Dialysis - methods; Stem cell transplantation; Stem cells; Tissue and Organ Harvesting - adverse effects; Tissue and Organ Harvesting - methods; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Venous access; Human; Stem cell; Catheter; Hematopoietic cell; Deep vein thrombosis; Cardiovascular disease; Long term; Blood; Central vein; Venous disease; Vascular disease; Autograft; Leukapheresis; Graft; Complication; Technique
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1701988

PBSC harvesting requires good quality venous access. The efficacy and complication rate of the venous access devices used during stem cell harvest in 101 consecutive patients were examined. Four different categories of venous access were used: (1) long-term dialysis central venous catheter (dCVC), (2) short-term dCVC, (3) peripheral venous cannulae (PVC), and (4) PVC and conventional central venous catheter. The number of harvest occasions per patient or harvest days per occasion were similar between the various categories of access. Complications during harvest occurred in 13 out of 48 (27%) occasions using a long-term dCVC compared to six out of 97 (6%) in the other three categories pooled together (P < 0.01). Forty-two of the 101 patients received a long-term dCVC to facilitate the harvest. The long-term dCVC was planned to stay in place and also be used as a conventional i.v. line during the following high-dose treatment. Twenty-one (50%) of the long-term dCVCs were removed due to complication. Thirteen (31%) of the long-term dCVCs were usable throughout the entire treatment period. In conclusion, we recommend that PBSC harvesting is performed through peripheral venous catheters when practically possible, otherwise via short-term dCVC.