•iron
•bloodglucose
•virusscreening-totestforvirusessuchas:humanimmunodeciencyvirus
(HIV), hepatitis B and C , cytomegalovirus (CMV) and syphillis.
This may seem like a lot of tests and therefore a lot of needle pricks, but remember
that several tests can often be done on one blood sample. In addition, a central
venous catheter (CVC) will be inserted before the transplant (see below). Blood can
be taken directly from this special line without causing you discomfort from frequent
needle pricks.
Central venous catheter (CVC) insertion
During your transplant you will need to have a number of intravenous (into the
vein) therapies. These may include fluids, chemotherapy, antibiotics, other drugs, and
blood and platelet transfusions. You will also need to have blood taken, often every
day, to check your progress. As well as being painful, the veins in your hands and
arms could not cope with frequent needle pricks. In addition, some drugs cannot
be given into the smaller veins in your hands and arms. It is for these reasons that a
central venous catheter (CVC) or central line is inserted prior to your transplant.
A central venous catheter is a special line inserted through the skin, into a large
vein in your neck or chest (this is usually done in a procedure room, the Radiology
department or an operating theatre). From here it travels all the way down the vein
and enters the top of the heart.
There are several different types of central lines used. The ones most commonly
used for transplant patients have 1, 2 or 3 lumens. The lumens are the separate thin
plastic tubes that hang on the outside, on top of your skin. The nurses will take blood
and give various infusions through these lumens, and you won‘t feel a thing. During
your transplant you may find that you sometimes have more than one infusion (for
example fluids and antibiotics) going through your central line at the same time.
This is perfectly safe. The nurses and doctors will examine your central line every day,
paying particular attention to the surrounding skin. Remember to report any pain,
redness or swelling around the central line as this might indicate that an infection
has developed.
The nurses will flush the lumens of your central line regularly, to keep them open and
flowing freely. They will also change the dressing which covers the site where the line
enters your skin. You may be taught how to care for your own line, especially if you
are going home with the line still in place.
Sometimes central lines need to be taken out, if for example they have become
infected and the infection is not responding to antibiotics. Whether or not the central
line is replaced will depend on where you are in your transplant process.
Like any invasive procedure carried out during your transplant, your written informed
consent is required for the insertion of a central line.
Pre-transplant ‘work-up’
19