Cathlink 20: a subcutaneous implanted central venous access device used in children with sickle cell disease on long-term erythrocytapheresis--a report of low complication rates

Abstract

Background: Experience with the use of central venous access device (CVAD) in children with sickle cell disease (SCD) on hypertransfusion is limited and published studies report wide variability in the rates of CVAD-associated complications.

Procedure: In this study, a total of 18 Cathlink 20 ports (Bard Access systems, Salt Lake City, UT) were implanted in 15 patients aged 7-20 years with SCD for 19, 230 catheter patient days.

Results: No peri-operative complications were observed. Three episodes of catheter occlusion requiring replacement occurred in two patients for an observed rate of 0.16 per 1,000 catheter patient days for thrombotic occlusion. One patient required port replacement and another patient required replacement twice. In 13 out of 15 patients, the median duration of port use was 45 months. No episode of catheter-associated bacteremia or catheter tunnel infections was observed.

Conclusions: Comparing our results with other reported studies of CVAD-associated complications in patients with SCD, we observed a lower rate of complications with the use of Cathlink 20 ports. These findings may be partly related to the design of the port and partly to a dedicated group of nurses accessing the ports in a controlled environment in an apheresis unit.