Liječnički vjesnik, Vol. 146 No. 3-4, 2024.
Izvorni znanstveni članak
https://doi.org/10.26800/LV-146-3-4-6
Removal of tunneled central venous catheter after kidney transplantation
Karlo Kurtov
Branislav Čingel
Željka Jureković
Bojana Maksimović
Ivan Margeta
Snježana Šulc
Bojana Šimunov
Ksenija Vučur Šimić
Lada Zibar
Sažetak
Aim: To present the experience of our kidney transplantation (TX) center regarding removing tunneled central venous catheter (CVC) after kidney TX. The optimal timing of CVC removal has not been known yet. Patients and methods: Forty-one patients (24 males, median age 60 years, 30 – 73) underwent removal of tunneled CVC after TX (kidney only or combined with pancreas or liver) from July 1st, 2018 to June 30th, 2023 (3 living donors, others deceased). The total number of patients that had tunneled CVC for hemodialysis (HD) at the time of TX among 249 patients who underwent TX at our center during that period was 41 (16.5 %). The timing was planned after the first protocol kidney transplant biopsy performed 2 months after the TX, and the decision was based on the biopsy findings and stable kidney graft function. The catheter was removed using standard procedure, and the patient was discharged several hours thereafter if no complications had occurred. Results: Thirty-seven patients had Hickman while four had Tesio type of CVC, 29 placed in the right, eight in the left internal jugular vein, three in the right subclavian vein, and one in the left femoral vein. The median time of removal after TX (n = 36) was four months (1 – 14, interquartile range 2 – 5). Kaplan-Meier analysis with five censored cases who were still waiting for removal showed a median time from TX to CVC removal of four months, 95% confidence interval 3.249 – 4.751. One patient had signs of tunnel infection and in one the removal was done due to non-catheter related sepsis. Three patients had unsuccessful first attempt of the removal, while one patient experienced moderate bleeding. Conclusion: Experience at our center showed the safety of the approach to remove tunneled CVC 3 – 5 months after kidney TX, with low infection and low bleeding risk.
Ključne riječi
CENTRAL VENOUS CATHETERS; RENAL DIALYSIS; DEVICE REMOVAL; KIDNEY FAILURE, CHRONIC; TIME FACTORS; RETROSPECTIVE STUDIES
Hrčak ID:
317656
URI
Datum izdavanja:
2.6.2024.
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