Introduction. The transplantation of allogeneic haematopoietic stem cells (allo-HSCT) is impossible without a central venous catheter (CVC).Aim. To determine an optimal approach to providing venous access during allo-HSCT.Materials and methods. This prospective, non-randomised, single-centre study included 146 patients (70 men and 76 women, median age 37 years) who underwent the fi rst allo-HSCT. Prior to conditioning, one of the following CVCs was placed: Hickman or Leonard tunnelled double-lumen silicone catheters (BardAccessSystem); polyurethane non-tunnelled CVCs without (Certofi x Duo, B. Braun) or with an antibacterial coating (Certofi x Protect Duo, B. Braun). The following complications were recorded: early complications, mechanical complications, catheter-associated thrombosis (CAT), catheterrelated bloodstream infections (CRBSI), as well as catheter exit-site and tunnel infections.Results. A total of 320 CVCs were placed (146 prior to allo-HSCT and 174 in the post-transplant period); 259 of the CVCs were non-tunnelled and 61 were tunnelled. Non-tunnelled CVCs were used for 1–123 days (median 22 days), whereas tunnelled CVCs were implanted for 9–621 days (median 146 days). The use of non-tunnelled CVCs was associated with 2.7 % (1.0/1000 catheter days) of mechanical complications and 9 % of CAT (1.4 / 1000 catheter days). The use of tunnelled CVCs was associated with the following complications: accidental removal — 1 (1.6 %), catheter rupture — 4 (6.5 %), CAT — 5 (8.2 %) patients (0.3 / 1000 catheter days); 18 (29.5 %) patients exhibited catheter obstruction, with CVC function being restored in 14 (77.7 %) patients, whereas in 4 (22.3 %) patients the CVC was removed. The incidence of CRBSI associated with non-tunnelled and tunnelled CVCs was 4.4 and 1.5 per 1000 catheter days, respectively. The study revealed no significant differences in the probability of developing CRBSI between non-tunnelled CVCs with and without antibacterial coating (p = 0.298), as well as between non-tunnelled and tunnelled CVCs in the fi rst 28 days after the catheter placement (p = 0.424). The risk of developing CRBSI when using tunnelled CVCs increased after 150 days of use.Conclusion. Allo-HSCT can be performed using any CVC type. Our study revealed no advantages in employing nontunnelled CVCs with an antibacterial coating compared to those having no coating. Tunnelled CVCs (as opposed to nontunnelled ones) provide the opportunity to employ a single catheter throughout the entire transplantation and post-transplant period. It should be noted that tunnelled CVCs should not be used for more than 150 days, since prolonged use of such CVCs significantly increases the risk of infection.Conflict of interest: the authors declare no conflict of interest.Financial disclosure: the study had no sponsorship.

Introduction. Haemophilia and von Willebrand disease constitute the most common hereditary coagulopathies. However, such rare hereditary coagulopathies as congenital factor V defi ciency can mistakingly be referred to these diseases.Aim. To describe the clinical manifestations and treatment of congenital factor V defi ciency.General findings. The article presents a literature review, as well as three case studies of patients with congenital factor V deficiency. Given that the choice of haemostatic therapy depends on accurate diagnosis, issues associated with the differential diagnosis of hereditary coagulopathies are considered as well. Patients with congenital factor V deficiency require continuous monitoring by a haematologist in order to control spontaneous or induced haemorrhagic syndrome, as well as to plan haemostatic therapy in case of surgical procedures, pregnancy or childbirth.Conflict of interest: the authors declare no conflict of interest.Financial disclosure: the study had no sponsorship.

Background. In the superior vena cava syndrome, vein catheterisation provides an alternative for vascular access. Few reports describe the usage of femoral ports.Aim. Description of pros and contras for femoral port installation in patients with haematological malignancies and the superior vena cava syndrome.Materials and methods. This prospective non-randomised, single-centre study included 163 haematological patients implanted 72 ports in superior vena cava, 35 — in inferior vena cava and inserted with 156 non-tunnelled femoral catheters. Catheterisation properties, complications, duration of use and reasons for port and catheter removal were registered.Results. No significant differences were observed between ports in superior and inferior vena cava as per the frequency of urokinase use in catheter dysfunction, catheter dislocation, catheter-associated bloodstream and pocket infections. Differences were revealed in the catheter-associated thrombosis rate, which was higher with femoral access (17.0 % or 0.9/1000 catheter days vs. 8.3 % or 0.2/1000 catheter days, p = 0.017). Ports in inferior vena cava had a lesser duration of use than in superior vena cava (p = 0.0001). Unlike femoral ports, non-tunnelled femoral catheters had higher rates of catheter-associated thrombosis (9/1000 vs. 0.9/1000 catheter days, p = 0.002) and infection (4.9/1000 vs. 0.3/1000 catheter days, p = 0.002). One lymphoma therapy course required one femoral port or 1 to 14 (median 3) non-tunnelled femoral catheters.Conclusion. Femoral port implantation is a necessary measure in patients with the superior vena cava syndrome. It has advantages in terms of catheterisation frequency, lower infectious and thrombotic complication rates compared to non-tunnelled femoral catheters.

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