A tale of two ports: an in vitro comparison of flow characteristics for therapeutic plasma exchange

Tunneled central venous catheters with ports are increasingly used for therapeutic apheresis procedures. Vortex ports have been used as access for therapeutic apheresis procedures, but are not ideal for therapeutic plasma exchange (TPE) procedures due to lower flow rates. We performed an in vitro experiment to compare flow characteristics of the single-lumen Vortex port (AngioDynamics) with the single-lumen TidalPort (Norfolk Medical). We used expired red blood cell units and adjusted the hematocrit to 40% with normal saline in a 2-L bag. We programmed the Spectra Optia (Terumo BCT) to run a 1.0-volume TPE with 5% albumin as replacement fluid. The TidalPort achieved flow rates of up to 110 mL/min without triggering alarms. Due to crucial alarms, the Vortex Port was not able to run at a flow rate higher than 90 mL/min, and multiple caution alarms were triggered at flow rates of 80 to 90 mL/min. These findings suggest that the TidalPort may be a suitable access option that provides flow rates similar to peripheral or central venous catheters for TPE procedures.