Maintenance Practices of Ports Used in Apheresis Procedures: A Survey

Background

Long-term apheresis patients require totally implantable vascular access devices (TIVADs) for treatments. In practice, TIVADs are replaced within 3 to 5 years.

Purpose

This quality improvement initiative aimed to investigate the current state of practice of TIVAD access and management in apheresis units across the United States.

Methods

Utilizing an electronic survey, institutions were asked questions focused on areas that may affect the patency and lifespan of TIVADs.

Findings

Of the 20 institutions who responded, 19 (95%) perform red blood cell exchanges (RBCXs) and 9 (45%) perform low-density lipoprotein (LDL) apheresis. The double-lumen vortex port is preferred for RBCX (n = 11, 58%). For LDL apheresis, 44% (n = 4) prefer arteriovenous fistula, and 33% (n = 3) the PowerFlow Port.

Discussion

There is variability in the care and maintenance of ports and no standard of care for maintaining TIVADs. A standard of care should be established to improve patient experience and outcomes.