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Midline for apheresis of peripheral blood stem cells

2015; Elsevier BV; Volume: 26; Linguagem: Inglês

10.1093/annonc/mdv345.26

1569-8041

F. Oleari, Patrizia Mordenti, Daniele Vallisa, Mauro Moretto, Cristina Arbasi, S. Bontini, S. Carini, Stefano Castellani, Cecilia Gozzo, O. Grassi, Monica Muroni, M.R. Cordani, Lorella Cappucciati, Luigi Cavanna,

Ethics and Legal Issues in Pediatric Healthcare

Background: The apheresis is a crucial phase in the stem cell donation in that it allows clinicians to obtain an adequate number of stem cells for bone marrow transplantation. When using peripheral blood stem cells, the apheresis process is possible only through a vascular catheter, usually inserted into a large vein in the arm of the donor. Then the blood goes through a machine that remove the stem cells and returns the blood to the donor. In this way, the stem cells can be collected and frozen until they are infused to the recipient. The apheresis process typically takes four to six hours and it need a large vein and a stable venous access in order to guarantee the adequate stem cells collection. Methods: After a careful revision of the literature on the best available venous access for apheresis of peripheral blood stem cells from the donor, we decided to use a peripheral venous access such as a midline. Results: During the mobilization phase, two midlines were placed one in each arm of the donor, into the basilica vein. The two peripheral inserted catheters were 5 French midlines placed in the upper third of the arm; in the left arm was placed a midline 10 cm in length and in the right arm a midline with a length of 12 cm. The first was used to collect the peripheral blood stem cells and the last one to return the blood to the donor. In a few hour we were able to collect an adequate number of peripheral blood stem cells without any complication or discomfort for the donor. Conclusions: We think that midline could be a valuable and cost-effective device when projecting apheresis of peripheral blood stem cells. In our opinion further research will be crucial in establishing the preferable gauge as well as the best length of the midline in order to guarantee the adequate collection of peripheral blood stem cellsand to reduce the discomfort for the donor.