Use of totally implantable catheters for peripheral blood stem cell apheresis

Carausu, Liana; Clapisson, Gilles; Philip, I; Sebban, H.; Marec‐Bérard, Perrine

doi:10.1038/sj.bmt.1705756

Cited by 13 publications

(8 citation statements)

References 24 publications

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“…volume 16 | JANuARY 2019 | 49 NATuRe RevIeWS | CliniCAl OnCOlOGy symptoms [50][51][52][53][54] (Table 1). Packed red blood cells (irradi ated) and/or albumin can be used to prime the collec tion in children weighing <30 kg.…”

Section: Admission Orders (For Patients Who Are Admitted Owing To Toxmentioning

confidence: 97%

Management guidelines for paediatric patients receiving chimeric antigen receptor T cell therapy

et al. 2018

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In 2017, an autologous chimeric antigen receptor (CAR) T cell therapy indicated for children and young adults with relapsed and/or refractory CD19 acute lymphoblastic leukaemia became the first gene therapy to be approved in the USA. This innovative form of cellular immunotherapy has been associated with remarkable response rates but is also associated with unique and often severe toxicities, which can lead to rapid cardiorespiratory and/or neurological deterioration. Multidisciplinary medical vigilance and the requisite health-care infrastructure are imperative to ensuring optimal patient outcomes, especially as these therapies transition from research protocols to standard care. Herein, authors representing the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Hematopoietic Stem Cell Transplantation (HSCT) Subgroup and the MD Anderson Cancer Center CAR T Cell Therapy-Associated Toxicity (CARTOX) Program have collaborated to provide comprehensive consensus guidelines on the care of children receiving CAR T cell therapy.

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Section: Admission Orders (For Patients Who Are Admitted Owing To Toxmentioning

confidence: 97%

Management guidelines for paediatric patients receiving chimeric antigen receptor T cell therapy

et al. 2018

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“…IVADs are frequently used in patients who have poor peripheral venous access and are in need of long‐term administration of vesicant drugs, antimicrobials, blood products, or parenteral nutrition . They also are used as access for long‐term therapeutic apheresis procedures . Although nonimplanted, long‐term catheters can be used for all of these purposes as well, the lack of an external component in IVAD ports provides multiple advantages; patients have improved perceptions of quality of life and body image and less limitation in their mobility .…”

Section: Ivad Port‐related Complicationsmentioning

confidence: 99%

“…A major design development in April of 2017 was the US Food and Drug Administration approval of the first long‐term apheresis‐specific port, the PowerFlow (BARD Peripheral Vascular, Inc.). Although IVADs have been used for apheresis access since the 1990s, there were frequent concerns about their long‐term durability (due to potential damage of the septum with frequent access) and with the ability to reach the optimal flows and pressures needed for the apheresis procedure . The PowerFlow design tries to overcome these issues and is based on the CathLink 20, a catheter initially marketed for chemotherapy and hypernutrition administration but used later for apheresis in both adults and children .…”

Section: Device Designmentioning

confidence: 99%

Implanted vascular access device options: a focused review on safety and outcomes

Blanco-Guzman

2018

Transfusion

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Implantable vascular access devices are frequently used in patients who have poor peripheral venous access. These devices can be partially implanted as tunneled and nontunneled central catheters, or they can be fully implanted as ports. Compared with long-term catheters, implanted ports have lower infection rates and improved perceptions of quality of life, but complications still occur in 2% to 18% of patients, frequently requiring removal of the device. Since the conception of implantable vascular access device ports, numerous advances in port design, materials, and techniques for implantation and care have been developed with the goal of overcoming frequent complications. We review the evidence related to these advances and their effect on the safety profile and complications of implantable vascular access device ports. Since the first report of a fully implantable vascular access device (IVAD) in 1982, 1 the use of these devices has grown exponentially. They consist of a reservoir cradled in the subcutaneous tissue that is connected to a catheter, with its tip terminating into a major vein. IVADs are frequently used in patients who have poor peripheral venous access and are in need of long-term administration of vesicant drugs, antimicrobials, blood products, or parenteral nutrition.2,3 They also are used as access for long-term therapeutic apheresis procedures. 4 Although nonimplanted, long-term catheters can be used for all of these purposes as well, the lack of an external component in IVAD ports provides multiple advantages; patients have improved perceptions of quality of life and body image and less limitation in their mobility. 5 These ports also minimize the need for maintenance care and risk of infectious complications when the IVAD is not in use. 6 These benefits of IVAD port use have also been demonstrated in pediatric cancer patients, with the added advantage of allowing the child to participate in normal activities and preserving body image. 7Despite the vast experience accrued over the years and the large volume of literature studying factors associated with IVAD port outcomes, early perioperative and late postoperative complications still occur (see Table 1). 8,9 Overall complication rates for IVAD ports reportedly occur in the range from 2% to 18% of all implanted devices. 10-12Port-related infections and venous thrombosis are particularly important, because they are associated with additional morbidity and costs and require removal of the IVAD as part of their treatment in as many as 6.5% of patients. 10 An additional complication specific to the use of IVAD ports during therapeutic apheresis is the occurrence of frequent pressure-related alarms, 13-15 which do not always result in a need to abort the procedure but can delay the duration of the treatments and require additional interventions. 13Here, we present a review focused on techniques, materials, and long-term management options of ports as IVAD options that have an impact on the relevant complications and overall safety profile of th...

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“…Implantable subcutaneous ports have been used for patients requiring chronic pheresis procedures, such as chronic red cell exchange or plasmapheresis. These ports are accessed with blunt, noncoring needles (55).…”

Section: Vascular Accessmentioning

confidence: 99%

Therapeutic Apheresis in Children: Special Considerations

Goldstein

2012

Seminars in Dialysis

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The provision of therapeutic apheresis to children is a technically challenging procedure, requiring trained personnel and an understanding of the disease processes that leads to the need for apheresis. Most apheresis protocols are derived from studies in adult patients, even though most studies are of limited sample size. The focus of this review is to highlight the disease processes commonly treated with therapeutic apheresis in children, and to address the technical considerations pertinent to the provision of safe and effective apheresis in the pediatric setting.

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Use of totally implantable catheters for peripheral blood stem cell apheresis

Cited by 13 publications

References 24 publications

Management guidelines for paediatric patients receiving chimeric antigen receptor T cell therapy

Management guidelines for paediatric patients receiving chimeric antigen receptor T cell therapy

Implanted vascular access device options: a focused review on safety and outcomes

Therapeutic Apheresis in Children: Special Considerations

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