Vascular access devices used during harvest of peripheral blood stem cells: high complication rate in patients with a long-term dialysis central venous catheter.
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.
Johansson
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Division of Haematology and Infectious Diseases, Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
Sollén Hansson
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Nilsson
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AS
Engervall
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P
D000293:Adolescent; D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007937:Leukapheresis; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods