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Introduction <p>Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) requires reliable vascular access for medication, transfusion, and blood sampling, which often involves painful venipuncture. This prospective study evaluated a novel dual peripherally inserted central venous catheter (PICC) technique to reduce venipuncture frequency in allo-HSCT recipients.</p> Methods <p>The study enrolled 29 allo-HSCT recipients. Each patient received two single-lumen PICCs: Catheter A for tacrolimus infusion and Catheter B, positioned distally, for blood sampling. Tacrolimus concentrations from Catheter B and venipuncture were compared using Bland–Altman analysis. Catheter-related adverse events were also evaluated to assess safety.</p> Results <p>PICC placement was successful in all patients. During 1378 catheter-days, one catheter-related bloodstream infection and one catheter occlusion occurred. Tacrolimus concentrations from PICC samples were strongly correlated with those of venipuncture samples (<i>r</i> = 0.93). Bland–Altman analysis showed good agreement, with a mean difference of 0.064&#xa0;ng/mL, limits of agreement within ± 2.0&#xa0;ng/mL, and no fixed bias.</p> Conclusion <p>Dual single-lumen PICCs provide a safe and accurate method for tacrolimus monitoring in allo-HSCT, and may improve patient experience by reducing the need for painful venipuncture. Further randomized-controlled trials are needed to confirm the benefits of this approach and assess its applicability to the monitoring of other therapeutic agents.</p>

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Accurate tacrolimus monitoring by dual peripherally inserted central catheters in allogeneic HSCT

  • 期刊论文

  • 发表日期：

    2025年9月8日

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  • Toshiro Sakai,
  • Rie Shoji,
  • Ryoji Tanaka,
  • Kyoko Yukitaka,
  • Ran Watanabe,
  • Yuzufumi Sekiguchi,
  • Ken Sato,
  • Saori Shimoyama-Ibuki,
  • Akari Goto,
  • Yuichi Konuma

摘要

Introduction

Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) requires reliable vascular access for medication, transfusion, and blood sampling, which often involves painful venipuncture. This prospective study evaluated a novel dual peripherally inserted central venous catheter (PICC) technique to reduce venipuncture frequency in allo-HSCT recipients.

Methods

The study enrolled 29 allo-HSCT recipients. Each patient received two single-lumen PICCs: Catheter A for tacrolimus infusion and Catheter B, positioned distally, for blood sampling. Tacrolimus concentrations from Catheter B and venipuncture were compared using Bland–Altman analysis. Catheter-related adverse events were also evaluated to assess safety.

Results

PICC placement was successful in all patients. During 1378 catheter-days, one catheter-related bloodstream infection and one catheter occlusion occurred. Tacrolimus concentrations from PICC samples were strongly correlated with those of venipuncture samples (r = 0.93). Bland–Altman analysis showed good agreement, with a mean difference of 0.064 ng/mL, limits of agreement within ± 2.0 ng/mL, and no fixed bias.

Conclusion

Dual single-lumen PICCs provide a safe and accurate method for tacrolimus monitoring in allo-HSCT, and may improve patient experience by reducing the need for painful venipuncture. Further randomized-controlled trials are needed to confirm the benefits of this approach and assess its applicability to the monitoring of other therapeutic agents.