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Use of arteriovenous shunts and right atrial catheters for daily granulocyte collection
Insights
Modified right atrial catheters offer a successful alternative to external arteriovenous shunts for granulocyte collection. This vascular access method proved reliable for donors undergoing apheresis procedures.
Area of Science:
- Hematology
- Transfusion Medicine
- Medical Devices
Background:
- Granulocyte collection via apheresis requires reliable vascular access.
- External arteriovenous shunts and central venous catheters are common methods.
- Comparing the efficacy and safety of different vascular access methods is crucial.
Purpose of the Study:
- To compare the effectiveness and safety of external arteriovenous shunts versus modified right atrial catheters for granulocyte donor vascular access.
- To evaluate the incidence of access failure and complications in both groups.
Main Methods:
- Adult granulocyte donors were randomized to receive either external arteriovenous shunts or modified right atrial catheters.
- Vascular access was used for daily granulocyte collections using blood cell separators.
- Data on access failure, infection, bacteremia, and achieved blood flow rates were collected.
Main Results:
- Access failure occurred in 6 of 32 donors with shunts versus 2 of 35 donors with right atrial catheters.
- Local infection and bacteremia rates were low in both groups.
- Achieved whole blood flow rates were comparable between shunts and catheters (50-65 ml/minute).
Conclusions:
- Modified right atrial catheters represent a safe and effective method for vascular access in granulocyte donors.
- This approach is a viable alternative to external arteriovenous shunts for apheresis procedures.
- The study supports the use of modified right atrial catheters for single-donor granulocyte collection.
Abstract:
Between June 1982 and April 1984, 67 adult granulocyte donors were randomized to receive external arteriovenous shunts or modified right atrial catheters as vascular access for daily granulocyte collections using blood cell separators. Six of 32 donors with shunts and 2 of 35 donors with right atrial catheters experienced failure of the access method. Local infection occurred in one donor with a shunt and one donor with a right atrial catheter. Bacteremia occurred in one donor with a right atrial catheter. Specified whole blood flow rates of 50-65 ml/minute were achieved with 28 of 32 shunts and 29 of 35 right atrial catheters (P = NS). The majority of the donors in each group tolerated the vascular access without significant problems. This study demonstrates that modified right atrial catheters can be successfully used as method of vascular access for single donor granulocyte collection with blood cell separators.