Summary: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 Ͻ 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 longterm 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. Keywords: PBSC collection; harvest; central venous access; central venous catheter; complication; thrombosis An increasing number of patients with various malignant disorders are undergoing high-dose therapy followed by autologous stem cells rescue as a part of their treatment. 1 PBSC collected by leukapheresis has become the main cell source in recent years. The procedure requires a high blood flow through intravenous (i.v.) lines between patient and apheresis machine. In some patients it is possible to use intravascular devices inserted in the peripheral arm veins, or to insert a femoral dialysis catheter. In other patients with a functional central venous catheter (CVC) already in place, this catheter can be used as the return line for blood from the leukaphereses machine to the patient. However, many patients need a double lumen central venous dialysis catheter (dCVC) to ensure harvesting. There are two different categories of dCVC, the stiff dCVC for short-term use 2 and the softer silastic dCVC for long-term use. 3The long-term type of dCVC can also be used for routine venous access, starting with delivery of chemotherapy for the mobilisation of stem cells through the period of highdose chemotherapy until bone marrow recovery. Most experience of long-term dCVCs has been collected in the haemodialysis setting. The majority of reported complications leading to removal of the long-term dCVCs are catheter-related infections (9-28%) 4-7 and failure due to poor flow rates or thromboses (5-30%). 4,[6][7][8][9][10] The published experience on use of long-term dCVC for stem cell harvesting is limited. 3,11,12 In March 1993 we decided to use long-term dCVC for stem cell harvesting and high-dose therapy in patients unable to have peripheral venous cannulae (PVC) due to poor ...