Chapter 21: Haematological procedures
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Complications
Overall rates of adverse reactions have decreased significantly over the past two decades. Greater understanding of the physiology of apheresis has guided continued improvements in technology and the potential for untoward effects has been minimized so that most procedures are performed without adverse events. This is especially true of donation procedures, which have become very routine (Crookston and Novak [26]). Caution is in order if cell or plasma removal exceeds current guidelines or if patients have underlying instabilities that predispose them to untoward events (Crookston and Novak [26]).
The use of central venous catheters can be associated with well‐described complications and these complications lead to the majority of fatalities associated with apheresis (Stroncek et al. [107]). Subclavian and superior vena caval catheters can be associated with perforation, haemothorax, pneumothorax, infection and thrombosis. The use of femoral catheters can be associated with the occurrence of haemorrhage, thrombosis and infection (Howell et al. [52]). These risks are reduced by experienced personnel inserting the catheters with the assistance of ultrasound (Stroncek et al. [107]).
