Double lumen port access in patients receiving allogeneic blood stem cell transplantation

Abstract

Summary:We performed a prospective trial investigating the feasibility of a double lumen port access in 26 patients with hematological malignancies or solid tumors receiving either standard conditioning (n ‫؍‬ 9, median age 49 years (range 19-65)) or dose-reduced conditioning (n ‫؍‬ 17, median age 56 years (range 35-66)) followed by allogeneic blood stem cell transplantation. The port system was implanted within 3 months (n ‫؍‬ 20, range 7-91 days) before transplantation or as indicated at different time points after transplantation (n ‫؍‬ 6, range 28-680 days). Most infusions, including the graft itself and all blood drawings, were performed via the port. Over a cumulative duration of 5622 days (1310 days after standard conditioning (range 56-349) and 4431 days after dose-reduced conditioning (range 49-489)) two port systems of patients receiving standard conditioning were removed due to early postimplantation pocket infection on day 6 and 8 after insertion, respectively. In the dose-reduced conditioning group only one late removal (day 287) of a port was required. Most of the patients in both groups reported less pain and a higher degree of comfort compared to peripheral or central venipuncture. The use of double lumen port access during conditioning and in an outpatient setting after allogeneic hemopoietic stem cell transplantation is feasible and advantageous for both patient and medical staff. Implantation several weeks before the start of conditioning might help in avoiding early infectious complications after conventional myeloablative conditioning. Bone Marrow Transplantation (2001) 28, 1067-1072. Keywords: double lumen port; allogeneic; dose-reduced conditioning Dose-reduced conditioning (DRC) followed by allogeneic stem cell transplantation (SCT) is increasingly performed

Totally implantable subcutaneous port system versus central venous catheter placed before induction chemotherapy in patients with acute leukaemia?a randomized study

“…There is no well-defined platelet count threshold for patients receiving a single-or doublelumen PORT, despite the fact that bleeding complications have been reported after PORT placement [10,13,19]. However, it is considered that major invasive procedures can be performed safely in patients with a platelet count of 40-5010 9 /l [22].…”

“…A single-lumen PORT is widely used in patients with solid tumours [1], and these PORTs have also been used in patients with AL during induction chemotherapy [12]. However, there is only limited experience of double-lumen PORTs in patients with haematological malignancies [19].…”

Systematic review: malfunction of totally implantable venous access devices in cancer patients

“…Four studies did not report the medical specialty of the inserter [12,43,50,61]. Although all studies reported functional outcomes, most focused on the insertion technique and complications of CPs (n=24) [4-6, 8, 15, 18, 20, 25-27, 29, 32, 38, 40-43, 45-47, 51, 59-61] or APs (n=11) [7, 9, 12, 16, 19, 33-35, 37, 48, 54].…”

Patients’ perceptions of having a central venous catheter or a totally implantable subcutaneous port system–results from a randomised study in acute leukaemia

“…The number of longterm CVC-associated bacteraemia per 1,000 catheter days in patients with haematological malignancies or solid tumours ranges between 3.0 and 8.4 [9,13,24]. The corresponding number in patients with a PORT ranges between 0.05 and 3.9 [1,2,9,20,24]. Thus, the PORT seems to be associated with a lower rate of catheter-related infections than the CVC.…”

“…The CVC has since then been elaborated and improved regarding material, shape and number of lumens. Various types of CVADs are currently available, and in patients requiring extensive intravenous therapy and frequent blood sampling the long-term CVC and the totally implantable subcutaneous port system (PORT) are commonly used [9,20,24].…”