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Replacement Versus Same-Site Salvage Using Hickman Catheter for Pediatric Stem Cell Transplantation Patients: A
Osama A Bawazir1, Soliman M Binyahib2, Razan Bawazir3
1Department of Surgery, Faculty of medicine, Umm Al-Qura University at Makkah, Makkah, Saudi Arabia; Department of Surgery, King Faisal Specialist Hospital & Research Centre, KSA, Jeddah, Saudi Arabia.
Annals of Vascular Surgery
|April 27, 2021
Summary
The same-site salvage technique for changing Port-a-Cath ports to Hickman lines is effective in pediatric bone marrow transplant patients, preserving vascular access. This method is recommended over replacement for noninfectious reasons.
Area of Science:
- Pediatric Hematology
- Vascular Access Management
- Bone Marrow Transplantation
Background:
- Children undergoing bone marrow transplant require double-lumen Hickman lines, necessitating Port-a-Cath port changes.
- Both same-site salvage and replacement techniques exist for this conversion, with ongoing debate regarding their comparative advantages.
Purpose of the Study:
- To compare the safety and effectiveness of replacement versus same-site salvage techniques for converting Port-a-Cath ports to Hickman lines in pediatric bone marrow transplant patients.
Main Methods:
- Eighty-five pediatric patients (0.2-15 years) undergoing stem cell transplant were divided into Replacement (n=47) and Same-site salvage (n=38) groups.
- Data on catheter duration, complications, and mortality were compared between groups before and after Hickman insertion.
Main Results:
- The Hickman catheter duration was significantly longer in the replacement group (4 months) compared to the same-site salvage group (1 month) (P=0.005).
- Increased age (OR: 1.31) and male gender (OR: 1.19) were identified as independent predictors of mortality.
- No significant differences in complications were observed between the groups regarding the initial port insertion.
Conclusions:
- The endovascular same-site salvage technique effectively preserves vascular access during tunnel catheter exchange for noninfectious indications.
- The same-site salvage technique is recommended for pediatric transplant patients undergoing Hickman line conversion.
