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Safety of Pediatric Peripheral Blood Stem Cell Harvest in Daycare Setting: An Institutional Experience

Melvin Alex Abraham1, Anup J Devasia2, Sajan Philip George1

  • 1Department of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India.

Anesthesia, Essays and Researches
|April 30, 2019
PubMed

Insights

Pediatric peripheral blood stem cell (PBSC) harvests can be safely performed as a daycare procedure outside the operating room. This study confirms the safety and feasibility of non-operating room anesthesia for pediatric PBSC donation.

Area of Science:

  • Pediatric Anesthesiology
  • Hematopoietic Stem Cell Transplantation
  • Daycare Procedures

Background:

  • Pediatric sibling donors require anesthesia or sedation for stem cell donation.
  • Peripheral blood stem cell (PBSC) harvest is often a daycare procedure due to time and space constraints.
  • Evaluating the safety of performing PBSC harvests outside the traditional operating room is crucial.

Purpose of the Study:

  • To determine the safety and feasibility of performing pediatric PBSC harvests in a hematology blood collection area as a daycare procedure.
  • To assess the outcomes of non-operating room anesthesia for pediatric PBSC donation.

Main Methods:

  • A secondary analysis of 164 pediatric PBSC harvests performed under anesthesia between 2009 and 2017.
  • Anesthesia involved inhalational sevoflurane or intravenous induction with various agents (propofol, dexmedetomidine, ketamine).
  • Monitoring included vital signs, with a focus on maintaining hemodynamic stability.

Main Results:

  • 137 donors (median age 5 years) received sevoflurane anesthesia, with laryngeal mask airway (LMA) used in 84 cases.
  • Respiratory and hemodynamic stability were maintained throughout the procedures.
  • Recovery was smooth, with a median wake-up time of 20 minutes.

Conclusions:

  • Non-operating room anesthesia for pediatric PBSC harvest is safe and successful.
  • Consultant anesthesiologists can effectively manage these procedures outside the operating room.
  • Daycare PBSC harvest in a hematology setting is a viable option for pediatric donors.
Abstract

Keywords:
Donor childrennonoperating room anesthesiapediatric central venous cannulationperipheral blood stem cell harvestrecovery timetotal intravenous anesthesia

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