Central venous access devices have become important tools in the manag
ement of pediatric patients with malnutrition, malignancy, and infecti
ons requiring long-term antibiotic treatment. Hemophilia presents a li
fetime challenge for venous access and at times can be an urgent or li
fe-threatening situation. Since 1986, the authors have implanted 11 su
bcutaneous infusion ports in nine patients with hemophilia. The system
s have remained in place for up to 7 years, without major complication
s or problems. Two cath eters were replaced, after 4 and 6 years, beca
use of skin erosion and blockage, respectively. One catheter was remov
ed after 7 years because of blockage following local trauma and was no
t replaced. A recent survey through the Canadian Hemophilia Centre Dir
ectors Group obtained a further 45 subcutaneous infusion ports in othe
r centers across Canada. The benefits of this system are overwhelming
enthusiasm by the parents and children and no major complications. Som
e of the patients are now HIV-positive and are able to use their syste
m for ongoing drug therapy. Copyright (C) 1994 by W.B. Saunders Compan
y