Image-guided central venous catheter placement for apheresis in allogeneicstem cell donors

Peripheral blood stem cell harvest by apheresis is an increasingly importan t procedure utilized in the treatment of many malignancies. Whether autolog ous or allogeneic, it is frequently performed via peripheral access because of concern over major complications associated with central Venous cathete r placement. This study was to determine the safety and success, complicati ons and premature failure rates for radiolocially placed ultrasound-guided nontunneled central venous catheters placed for apheresis in a donor (allog eneic) population. One hundred central venous catheters were placed in nine ty-one individuals for allogeneic stem cell harvest. Procedural success and complications relating to placement were noted in all. In 97 cases the num ber of needle passes required for venous cannulation and whether this was a chieved with a single wall puncture was noted. Duration of catheterization and reason for removal were recorded in all cases. All catheters were place d by a right transjugular route. Venous cannulation and functioning line pl acement was achieved in every case; 92/97 (95%) required only a single need le pass and 84/97 (87%) only a single wall puncture. There were no placemen t related complications; 94 catheters were removed the same day with the re mainder removed within 48 hr. All completed apheresis. Our study demonstrat es the safe use of central venous catheters for apheresis in normal donors if ultrasound guidance is used for the puncture and the duration of cathete rization is short. J. Clin. Apheresis 15:173-175, 2000. (C) 2000 Wiley-Liss , Inc.