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Complications related to totally implantable venous access devices in children and adults following lung transplantation
Author(s) -
Cho Joshua K.,
Acord Michael,
Goldfarb Samuel B.,
Reddy Shilpa N.,
Goldberg Hilary J.,
Courtwright Andrew M.
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13465
Subject(s) - medicine , lung transplantation , surgery , poisson regression , complication , transplantation , venous access , retrospective cohort study , lung , catheter , population , environmental health
Totally implantable venous access devices ( TIVADs ) are the preferred devices for patients with advanced lung disease who require long‐term venous access. The primary purpose of this study was to describe the natural history of TIVADs left in place at the time of transplant. Methods This multicenter retrospective cohort study evaluated pediatric and adult lung transplant recipients from 5/5/2005 to 12/31/17 with pretransplant TIVAD . Incident rates ( IR ) for infectious and mechanical complications were calculated. Poisson regression models were used to identify TIVAD characteristics associated with complications. Results Of 1253 transplant recipients, 82 (6.5%) had pretransplant TIVAD . Five (6.1%) TIVAD s were removed at transplantation. Fifty‐five (67.1%) TIVAD s were eventually removed, most commonly because they were no longer required (50.9%) or because of infection (25.5%). Overall incident rates ( IR ) of infectious or mechanical complications were 0.33 and 0.14, respectively. The IR of infection was highest within one year of transplant, particularly during the index hospitalization ( IR = 1.67). Youngest tertile (<22 years) had the lowest incident rate ratio of TIVAD infections ( IRR = 0.22). Conclusion Although TIVAD complication rates in lung transplant recipients are similar to non‐transplant and other immunocompromised patients, TIVAD removal at transplant or within the first post‐transplant year may minimize the risk of TIVAD infections.