If you’re donating your stem cells via the PBSC method, there is a small chance you might need to have a central line placed instead of donating your stem cells through the veins in your arms.
To help you understand why this might happen and what it would involve, this page has the key things to know, including:
- What a central line is
- Why you might need to have a central line and when you would find out
- How a central line is placed
If you have any questions or concerns, please don’t hesitate to contact your Donor Provision Coordinator at Anthony Nolan.
What is a central line?
A central line, or ‘catheter’, is a temporary, soft plastic tube that is placed in a larger vein, usually in the groin or neck. It’s regularly used with patients when they need to be given fluids or medication that may irritate a smaller vein.
Why are central lines sometimes needed for stem cell donation and when would you find out?
In a small number of cases, the veins in your arm are found to be unsuitable for placing the needles needed to collect the stem cells. This means we need to use a larger vein in the neck (called the ‘jugular vein’) or in the groin (called the ‘femoral vein’).
Can you reduce the chances of needing a central line?
It will entirely depend on how the veins in your arms are on the day, and whether the needles can be placed there. The best advice is to make sure you’re well hydrated before your donation.
When do you find out if you need a central line?
Your veins will be assessed at your medical, and if they doctors think they’re too small to be used for the donation, they’ll let you know then that you will need a central line.
On the day of your donation, your veins will be reassessed to see if things have changed. If your veins are smaller, or if there’s any difficulty donating through your veins on the day, then you could be referred for a central line.
In both cases, the doctors at the collection centre will fully explain what having a central line involves and give you a chance to ask any questions. You’ll then be asked to sign the relevant consent form.
Are there any alternatives to having a central line?
If you can’t donate through the veins in your arms, then the only way to carry on with a PBSC donation is with a central line. You do have the option of saying no to a central line, and this means the donation will not go ahead.
How is a central line placed?
Who places the central line?
Once you have agreed to having a central line and signed the relevant consent forms, an experienced anaesthetist, radiologist or appropriately qualified haematology specialist will place the central line.
When and where does it happen?
The central line will be placed in the morning of the first day of donation.
Some hospitals will have the equipment to place the central line on the ward, while others will take you to the radiology department. If you have to go to a different department, or if the doctors hadn’t decided you needed a central line in advance, the start of your donation might be delayed and you might finish donating later than expected.
Do you need to prepare differently to have a central line?
No, you don’t need to prepare any differently for having a central line. You’ll be given a hospital gown to change into before it’s placed.
Does a central line hurt?
You’ll have a local anaesthetic to numb the skin at the insertion point. The placement should not hurt in any way, but it may be more uncomfortable than having the needles in your arms, although you will be able to move your arms around more.
How long does the central line stay in for?
The central line will be in for a maximum of two days. If you’re needed for a second day of donating, you will be kept in hospital overnight so the central line can stay in place. If your donation only takes one day, the central line will be taken out once your stem cells have been collected and counted.
Are there any adverse effects of having a central line?
Serious complications do exist, but they are very rare. These include internal bleeding and air embolus (less than 0.5%), and where central lines are placed in the neck, they could result in pneumothorax where air or gas collects in the pleural space of the lung (less than 4%).
Other complications include local bleeding; local infection (signs of this include redness, warmth and tenderness as the insertion site); systemic infection (signs of this include fever, nausea/vomiting and malaise); and thrombus, where a blood clot firms.
Occasionally the central line doesn’t function properly or may become blocked. This just means it would need to be removed.
The risks associated with a central line for healthy stem cell donors are minimal, and you’ll be closely monitored the whole time to check for any reactions so they can be dealt with quickly.
If you have any questions or want any more information about central lines, please speak to your Coordinator.