Laser Doppler Flowmetry as a Predictive Tool for Poor Venous Flow in Leukapheresis

Area of Science:

• Hematology
• Medical Devices
• Cardiovascular Physiology

Background:

• Compromised cell collection during leukapheresis is often linked to poor venous flow.
• Predicting and mitigating poor venous flow remains a challenge in apheresis procedures.
• Limited reliable predictors exist for identifying individuals at risk of poor venous flow.

Purpose of the Study:

• To identify predictors of poor venous flow during leukapheresis.
• To evaluate the utility of laser Doppler flowmetry (LDF) in monitoring venous flow.
• To assess the feasibility of pre-procedural risk stratification for leukapheresis.

Main Methods:

• Retrospective analysis of 146 leukapheresis procedures in patients and healthy donors.
• Continuous monitoring of peripheral blood flow using laser Doppler flowmetry (LDF).
• Definition of poor venous flow as a >10% reduction in draw rate due to low inlet pressure.

Main Results:

• Poor venous flow occurred in 29.1% of patients and 26.9% of donors.
• Independent predictors in patients included multiple myeloma, lower baseline blood flow, and higher pulse amplitude.
• Older age was an independent predictor in donors; LDF detected flow decrease preceding other hemodynamic changes.

Conclusions:

• Laser Doppler flowmetry (LDF) shows potential for predicting poor venous flow during leukapheresis.
• Identifying predictors can aid in pre-procedural risk stratification for apheresis.
• LDF monitoring may improve cell collection efficiency by anticipating flow issues.