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A case review of a patient experience of photopheresis using a peripherally inserted central catheter
Cherie Rushton1, Andrew Jackson2, Kathryn Goddard1
1Photopheresis, Rotherham Foundation Trust, Rotherham, United Kingdom.
Insights
Peripherally inserted central venous catheters (PICCs) provide a viable vascular access solution for patients undergoing extracorporeal photopheresis (ECP), particularly those with graft-versus-host disease (GVHD). This case report highlights successful ECP treatment facilitated by PICC line insertion.
Area of Science:
- Immunomodulatory therapy
- Hematology
- Vascular access
Background:
- Extracorporeal photopheresis (ECP) is an immunomodulatory therapy requiring reliable vascular access.
- Graft-versus-host disease (GVHD) often complicates venous access in patients undergoing ECP due to prior treatments and skin changes.
Observation:
- Patients with GVHD frequently present challenges for ECP teams due to compromised venous access.
- Peripherally inserted central venous catheters (PICCs) represent a potential alternative for vascular access in this patient population.
Findings:
- This case report details the successful application of ECP in a patient who received a PICC line for vascular access.
- The PICC line facilitated uninterrupted ECP treatment, overcoming previous access difficulties.
Implications:
- PICC lines can effectively enable ECP in patients with challenging venous access, such as those with GVHD.
- Implementing PICC lines may improve treatment continuity and outcomes for ECP patients with complex medical histories.
Abstract:
Extracorporeal photopheresis (ECP) is a cell based immunomodulatory therapy in which the patient is attached intravenously to a cell separating machine. During ECP a patient's blood is collected via either a central venous access device (CVAD) or a peripherally inserted 16G arterial venous fistula needle in either one or both antecubital fossa. However, patients presenting for ECP with GVHD repeatedly present a challenge to the ECP team due to poor venous access resulting from previous therapies and skin changes. The use of peripherally inserted central venous catheters (PICCs) offers an alternative route of vascular access for this cohort of patients. Here we present a case report of a patient successfully treated with ECP following the insertion of a PICC line.
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