title: Performance of a hybrid central venous catheter utilized for both peripheral blood stem cell harvest and transplant support of patients undergoing autologous peripheral blood stem cell transplantation.
abstract: Patients undergoing autologous peripheral blood stem cell transplantation (PBSC) frequently require the sequential insertion of two central venous catheters, one for leukapheresis and one for transplant support. Hybrid catheters suitable for leukapheresis and long-term use have been increasingly used, but there is limited information regarding their performance and complication rate. The purpose of this study was to determine the performance of the Pheres-Flow hybrid catheter when utilized for both leukapheresis and transplant support, with particular emphasis on the incidence of infectious and occlusive complications. We prospectively analyzed the performance of 92 catheters in 82 consecutive patients who underwent autologous peripheral blood stem cell (PBSC) transplantation. Occlusion was the most frequent complication of this catheter with 29% of the patients experiencing difficulty drawing blood or infusing fluids. Infection was another frequent complication. Twenty-two percent of patients developed catheter-related bloodstream infections and 15 catheters had to be removed because of proven or suspected infection that did not respond to antibiotic therapy. Nevertheless, 77% of patients were able to complete leukapheresis and transplant support with only one catheter. We conclude that the utilization of the Pheres-Flow catheter for both leukapheresis and transplant support is feasible, but that new strategies need to be developed to decrease the incidence of occlusive and infectious complications of hybrid catheters.
authors.affiliation: Department of Medicine, University of Texas Health Science Center, San Antonio, USA.
authors.forename: A
authors.initials: A
authors.lastname: Restrepo
authors.forename: P
authors.initials: P
authors.lastname: Devore
authors.forename: C E
authors.initials: CE
authors.lastname: Encarnación
authors.forename: M H
authors.initials: MH
authors.lastname: Wholey
authors.forename: D
authors.initials: D
authors.lastname: Schneider
authors.forename: N S
authors.initials: NS
authors.lastname: Callander
authors.forename: H
authors.initials: H
authors.lastname: Ferral
authors.forename: D
authors.initials: D
authors.lastname: Postoak
authors.forename: J E
authors.initials: JE
authors.lastname: Anderson
authors.forename: T
authors.initials: T
authors.lastname: Walsh
authors.forename: G
authors.initials: G
authors.lastname: Padayao
authors.forename: E
authors.initials: E
authors.lastname: Gokmen
authors.forename: A
authors.initials: A
authors.lastname: Ehsan
authors.forename: L
authors.initials: L
authors.lastname: Ochoa
authors.forename: B
authors.initials: B
authors.lastname: Neumon
authors.forename: G
authors.initials: G
authors.lastname: West
authors.forename: M I
authors.initials: MI
authors.lastname: Restrepo
authors.forename: J
authors.initials: J
authors.lastname: Przykucki
authors.forename: J
authors.initials: J
authors.lastname: Patterson
authors.forename: C O
authors.initials: CO
authors.lastname: Freytes
mesh_terms: D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005334:Fever; D006801:Humans; D007239:Infections; D007937:Leukapheresis / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000295:instrumentation*; D011446:Prospective Studies; D014182:Transplantation, Autologous