Ultrasound-Guided Peripheral Venous Catheter for Automated Erythrocytapheresis in a Paediatric Population Affected by Sickle Cell Disease.

INTRODUCTION

Automated erythrocytapheresis (aEEX) is an effective therapy for severe sickle cell disease (SCD). Its use in paediatrics can be limited by challenges in obtaining reliable venous access.

METHODS

We conducted a retrospective, single-centre study to evaluate the safety and feasibility of ultrasound (US)-guided peripheral venous catheter (PVC) placement for aEEX compared with central venous catheter (CVC) use in children and adolescents with SCD.

RESULTS

Between May 2018 and July 2025, 99 aEEX procedures using PVC were compared with 44 using CVC in 23 patients (median age: 16.4 years). The most frequent indication was severe disease phenotype (62.9%), defined as recurrent vaso-occlusive crises and/or splenic sequestration and/or acute chest syndrome despite optimal hydroxyurea therapy. The procedure success rate was 99.0% for PVC and 97.7% for CVC, with median post-apheresis HbS of 26.5% and 24.0%, respectively. Complications, mostly transient and without clinical impact, occurred in 9.1% of PVC procedures and 6.8% of CVC procedures. No infectious or and thrombotic events were reported.

CONCLUSIONS

These findings indicate that aEEX under light sedation with US-guided PVC placement is a safe, well-tolerated and effective alternative to CVC in selected paediatric patients with SCD. This approach may expand access to aEEX reducing reliance on CVC and manual exchange procedures.

TRIAL REGISTRATION: The authors have confirmed clinical trial registration is not needed for this submission.