Venous access for hematopoietic progenitor cell collection: An international survey by the ASFA HPC donor subcommittee

O'Leary, Mandy Flannery; Dunbar, Nancy M.; Kim, Haewon C.; Draper, Norman R.; Linenberger, Michael; Schwartz, Joseph; Miller, Yvette Marie; Murtaugh, Ally; West, F. Bernadette; Fernando, Leonor P; Park, Yara A.

doi:10.1002/jca.21445

Cited by 15 publications

(23 citation statements)

References 12 publications

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“…Nevertheless, anecdotally reported utilization of CVC access remains very high for all procedures. The literature is less clear as there is a paucity of data relating specifically to access used in TA procedures …”

Section: Introductionmentioning

confidence: 99%

Is peripheral access for apheresis procedures underutilized in clinical practice?—A single centre experience

Putensen

Leverett

Bhavika

et al. 2016

J of Clinical Apheresis

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Section: Introductionmentioning

confidence: 99%

Is peripheral access for apheresis procedures underutilized in clinical practice?—A single centre experience

Putensen

Leverett

Bhavika

et al. 2016

J of Clinical Apheresis

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“…Central venous catheters are commonly used as an alternative to peripheral venous access; however, placement and maintenance of central venous catheters are associated with risks such as pneumothorax, hemothorax, hematoma, arterial puncture, air embolism and infections . Avoiding a central venous catheter reduces the risk of harm …”

Section: Resultsmentioning

confidence: 99%

“…7 Avoiding a central venous catheter reduces the risk of harm. [9][10][11] 3.3 | Recommendation 2 3.3.1 | Do not routinely use plasma as replacement fluid for therapeutic plasma exchange (TPE) unless there is a clear indication to replete a plasma component TPE involves the removal of a patient's plasma that contains substances such as pathologic antibodies, immune complexes, cryoglobulins, toxins, or lipids, associated with the patient's disease condition. 12 Due to the removal of a large volume of plasma during TPE, a replacement colloid fluid such as albumin or plasma is necessary to maintain isovolemia.…”

Section: Recommendation 1 321 | Do Not Place a Central Venous Catmentioning

confidence: 99%

Choosing Wisely for apheresis

Connelly‐Smith

Tanhehco

Chhibber

et al. 2018

J of Clinical Apheresis

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The Choosing Wisely campaign has stimulated clinicians to think about the appropriateness of various tests and procedures, compelling physicians to make smarter, safer and more effective choices for high quality patient care and to reduce healthcare cost. The American Society for Apheresis (ASFA) strives to advance apheresis medicine through education, evidence‐based practice, research and advocacy. To complement these shared missions, ASFA created a working group, consisting of representatives from the various ASFA committees, to produce recommendations for apheresis medicine that reflect the Choosing Wisely guiding principles. A diverse group of ASFA physician and allied health members reviewed, rated and ranked 9 original draft proposals. Additional revisions and refinements were made prior to external review and adoption of five final recommendations by the ASFA Board of Directors. The ASFA Choosing Wisely recommendations encourage apheresis practitioners, patients and donors to discuss and prioritize best clinical practices that avoid harm and waste while optimizing clinical benefit.

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“…Hospital policies vary in their protocols related to the service used for placing CVCs, catheter capping, and catheter maintenance. In a recent survey of 100 centers performing cellular collections, the interventional radiology service inserted the majority of catheters for both autologous and allogeneic donors . Most centers used heparin to cap catheters but differed significantly in the concentration of heparin used.…”

Section: Vascular Access For Cellular Collectionsmentioning

confidence: 99%

“…Surprisingly, citrate or saline was used only in 8% and 10% of centers, respectively, for autologous donors. Tissue plasminogen activator is frequently used by centers to address catheter thrombosis, which most perform as an instillation for up to 1 hour …”

Section: Vascular Access For Cellular Collectionsmentioning

confidence: 99%

Cellular collection by apheresis

Padmanabhan

2018

Transfusion

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Cellular collection is an important and increasingly used apheresis procedure. These collections are performed by leukocytapheresis, a procedure involving the removal of a patient's or donor's white blood cells, and are used to collect hematopoietic progenitor cells, specific cell populations (such as T‐lymphocytes), and granulocytes. Hematopoietic progenitor cell apheresis and T‐lymphocyte collection are performed by procedures that enrich for mononuclear cells. Hematopoietic progenitor cells are used for autologous and allogeneic hematopoietic stem cell transplantation, whereas T‐cell collection is being used increasingly in novel cellular therapy approaches and for donor lymphocyte infusions to induce graft‐versus‐leukemia effect. Granulocytes are collected from healthy donors to treat severe sepsis in patients who are refractory to antimicrobial therapies. Less frequently, cellular depletion of leukocytes may be indicated in leukemic patients who have severe hyperleukocytosis resulting in leukoaggregation and decreased tissue perfusion. In these procedures, establishing and maintaining adequate vascular access are critical prerequisites to ensuring a successful procedure. For most types of leukocytapheresis procedures, efforts should be made to ensure that they are performed using peripheral veins, and the use of an intravascular access device should be considered only after it is determined that peripheral access is not feasible or desirable. However, in some settings (such as in patients undergoing autologous hematopoietic stem cell transplantation), intravascular access devices are often used to facilitate both the leukocytapheresis procedure and the subsequent transplant. Here, different types of vascular access approaches used in cellular collections are discussed, and this information is supplemented by the author's experience and practice in areas where published information is limited.

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Venous access for hematopoietic progenitor cell collection: An international survey by the ASFA HPC donor subcommittee

Cited by 15 publications

References 12 publications

Is peripheral access for apheresis procedures underutilized in clinical practice?—A single centre experience

Is peripheral access for apheresis procedures underutilized in clinical practice?—A single centre experience

Choosing Wisely for apheresis

Cellular collection by apheresis

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