Retrospective Evaluation of Dual Specialty Ports in Therapeutic Apheresis

Dual specialty ports were evaluated for safety and efficacy in therapeutic apheresis by analyzing outcomes across 97 port placement events in 88 patients, focusing on two configurations: dual Bard PowerFlow (BP2) and a combination of Bard PowerFlow with AngioDynamics SmartPort (BP + AD). This retrospective cohort study was conducted at a tertiary care center from December 2017 to July 2024 and included 97 port placement events (194 total ports) across 88 patients with conditions such as bronchiolitis obliterans, sickle cell disease, myasthenia gravis, and graft-versus-host disease who required therapeutic apheresis. Measured outcomes included port revisions, removals, total port days, and complications. The BP2 configuration was used in 43 events (44.3%), and the BP + AD configuration in 54 events (55.7%). Common indications included bronchiolitis obliterans (40.2%), sickle cell disease (17.5%), myasthenia gravis (12.4%), and GVHD (12.4%). Revisions were necessary in 5.7% of ports due to mechanical issues or thrombosis, while 36.1% of ports were removed, mainly due to infection/bacteremia or completion of therapy. Port functionality ranged from 22 to 2080 days, with a mean of 564 days. The mortality rate during follow-up was 21.6%. Dual specialty ports demonstrate viable long-term access for therapeutic apheresis in selected patients, with functionality extending from months to years. Success appears highly dependent on patient selection, with infection risks particularly notable in immunocompromised populations. These findings support the use of specialty ports as an alternative to traditional tunneled catheters, particularly for those with preserved immune function requiring chronic therapy.