Reply To: Stem Cell Infusion Tubing

  • Stephanie Davis

    Member
    September 25, 2018 at 9:18 pm


    Hi Dyanne,

    What brand of stem cell tubing is being discontinued that you use at your institution?

    See below for answers to your questions:

    1. Do you use a Y-type set up to infuse stem cells? If so, what brand/manufacturer?
    We do use a Y-type set up at CHLA to infuse stem cells. Our Y spike adapter is from OriGen Ref # 2S-P20. We use this piece with 2 of our CareFusion gravity sets (104in.) Ref # 41173E.

    2. Do you “rinse” the stem cell bag at the completion of the infusion?
    We do rinse our stem cell bags with 20-30mL per policy at completion of infusion (per “back priming)

    3. Does the tubing set you use have a filter?
    Our tubing set does not have a filter. If one is needed per MD order we use this:IV Blood Component 170-260 micron Filter (Fenwal 4C2160)

    4. Anything else I should know about your practice of stem cell infusions?​​
    We also assure order is written to hold other IV fluids (i.e. PN, immunosuppressant drips for Allogeneic
    patients, etc.) during infusion. No lipids 24 hours before and after HPC/TC infusion per policy. We have been using NS IVH pre/post products on some occasions to create a more isotonic environment for stem cells. 

    Thank you!
    Stephanie

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    Stephanie Davis, BSN,RN CPHON
    BMT Clinical Educator
    Children’s Hospital Los Angeles
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    Original Message:
    Sent: 02-20-2018 03:04 PM
    From: Dyane Bunnell
    Subject: Stem Cell Infusion Tubing

    ​I am interested in learning about the tubing that centers are using for infusion of hematopoietic stem cells via a bag.
    For years, our center has been using a Y-type gravity infusion set (with 2 bag spikes — one for saline, one for stem cells) without a filter. This set up has allowed us to “rinse” the stem cell bag with saline to remove/infuse any remaining stem cells at the end of the infusion.

    I recently learned that this particular tubing set is being discontinued, prompting me to ask about everyone’s practice of infusing stem cells from a bag.

    According to the AABB Circular of Information for the Use of Cellular Therapy Products, it is permissible to use a filter (170-260 micron) designed to remove clots and (obviously) NOT a filter that is designed to remove leucocytes. However, I know that most centers are reluctant to use any kind of filter.

    Here are my questions:
    1. Do you use a Y-type set up to infuse stem cells? If so, what brand/manufacturer?
    2. Do you “rinse” the stem cell bag at the completion of the infusion?
    3. Does the tubing set you use have a filter?
    4. Anything else I should know about your practice of stem cell infusions?

    Many thanks in advance for your responses!

    Dyane

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    Dyane Bunnell, APRN,CPON,MSN,RN
    Clinical Nurse Specialist
    Wilmington, DE
    United States
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