418: Analysis of outcomes for vascath insertion for paediatric peripheral blood stem cell collection: A queensland experience

Abstract

Haematopoietic stem cell transplantation is now a standard procedure used for many paediatric oncology conditions. The stem cells can be collected from 3 different sources, bone marrow, cord blood and from peripheral blood.Peripheral blood stem cells are harvested following stem cell mobilisation into the peripheral blood. Standard practice in adult units is to insert a large bore or 14Gauge peripheral cannula. However in children this is not practical, so another option is required. The use of standard central venous catheters (CVC) is not possible due to the large flow rate required which can collapse the standard CVC. It is the standard of practise at the Royal Children’s Hospital to insert an apheresis catheter to the jugular or subclavian veins. This catheter is inserted and remains insitu until the peripheral blood stem cell collection is completed. There is little data published on the complications arising from this practice in paediatrics unless inserted in the femoral vein. This paper will discuss our institutional practice and current outcomes noted in relation to peripheral blood stem cell collections and the use of large rigid apheresis catheters. Haematopoietic stem cell transplantation is now a standard procedure used for many paediatric oncology conditions. The stem cells can be collected from 3 different sources, bone marrow, cord blood and from peripheral blood. Peripheral blood stem cells are harvested following stem cell mobilisation into the peripheral blood. Standard practice in adult units is to insert a large bore or 14Gauge peripheral cannula. However in children this is not practical, so another option is required. The use of standard central venous catheters (CVC) is not possible due to the large flow rate required which can collapse the standard CVC. It is the standard of practise at the Royal Children’s Hospital to insert an apheresis catheter to the jugular or subclavian veins. This catheter is inserted and remains insitu until the peripheral blood stem cell collection is completed. There is little data published on the complications arising from this practice in paediatrics unless inserted in the femoral vein. This paper will discuss our institutional practice and current outcomes noted in relation to peripheral blood stem cell collections and the use of large rigid apheresis catheters.