BACKGROUND: Thrombolytic therapy with urokinase 5000 units has been the standard therapy for the restoration of thrombosed central catheters. However, with the decreased availability of urokinase, alternatives needed to be sought. The aim of the study was to determine the efficacy, bioactivity, dwell time and cost of cryopreserved recombinant tissue plasminogen activator (rTPA) in the restoration of occluded central venous access devices. MATERIALS AND METHODS: For children < 10 kg, a dose of 0.5 mg, and for children >10 kg, a dose of 1mg was used. The dwell time was 1-2 hours. RESULTS: Of the 40 courses of rTPA, 39 fully restored central venous line patency (97%). Successful courses were instilled for an average of 1 hour. CONCLUSION: Cryopreserved rTPA appears to be safe and effective in the dose used to restore the patency of occluded central venous access devices in pediatric oncology patients.
BACKGROUND: Thrombolytic therapy with urokinase 5000 units has been the standard therapy for the restoration of thrombosed central catheters. However, with the decreased availability of urokinase, alternatives needed to be sought. The aim of the study was to determine the efficacy, bioactivity, dwell time and cost of cryopreserved recombinant tissue plasminogen activator (rTPA) in the restoration of occluded central venous access devices. MATERIALS AND METHODS: For children < 10 kg, a dose of 0.5 mg, and for children >10 kg, a dose of 1mg was used. The dwell time was 1-2 hours. RESULTS: Of the 40 courses of rTPA, 39 fully restored central venous line patency (97%). Successful courses were instilled for an average of 1 hour. CONCLUSION: Cryopreserved rTPA appears to be safe and effective in the dose used to restore the patency of occluded central venous access devices in pediatric oncology patients.