BETA - Can patients have visitors during ASCT?

Can patients have visitors during ASCT? We discourage that because you can have a couple of caregivers that can alternate, but now with the COVID we don't allow the visitor to come and so the caregiver, you know, they can drop the patient and then come back, but we don't allow the caregiver to stay in the clinic with us because all the patients are there. And so we, you know, and we recommended that COVID vaccinated now and they also the caregiver, they have to use a lot of precautions. We don't want the caregiver to go out and then expose the patient. So but we do occasionally we have patient, they don't have a good social support and we have to admit them to the hospital in the hospital for the duration of transplant, but we like to do the outpatient if possible. Do I need a catheter when doing a transplant? You need a catheter. Yeah, right. You are talking about the central line. Yes, because it's high dose chemotherapy and I guess, you know, it's not necessarily just for that during the transplant and then you get the stem cells infusion. So you want a large catheter to infuse the stem cells and also use the catheter to collect the stem cells. So you need a Hickman catheter because the portacad will not be appropriate for a couple of reasons. One, because you're not going to be able to collect the stem cells. They go through the skin, you destroy the stem cells and also because if you develop an infection, you will need to go through surgery. With the Hickman catheter, we pull it, you know, if you have an infection. So it's easy to manage. And also during the transplant, every day you get blood draw, you need the infusion, antibiotics, electrolytes. So you need the catheter. It's your best friend. And I always tell the patient, we'll place it for the stem cells collection and then we pull it, you know, two weeks after when you engraft. So it's a very temporary line. What is the difference between a catheter and a portacad? The portacad is a catheter that is inserted by the surgery or the interventional radiology. So they actually make an incision and it's on there so you don't see anything and then you have to access the portacad. But we don't use that for transplant. For the stem cells collection, we don't. And also because during the transplant, that week that the patient developed the myelosopression, if you have an infection and the portacad gets infected and you don't have blackout, platelets, you know, the surgery will not touch it. So the ichman, the one sticking out and we need, you know, large lumen ichman, we can pull it at any time. So if you have an infection midterm, you know, when you are in the middle of transplant and we isolate an organism, a bacteria, we can pull that and finish the transplant with a PIC or a regular IV. Can individuals on dialysis consider transplant as an option? I do a lot of patient on dialysis. I actually have a lot of experience on dialysis. Here at Duke, I offer the dual approach where I, patients on dialysis have difficulty with the myeloma because they are not candidates for clinical trials. They have less options. So I do the autologous transplant and then I actually do the kidney transplant. I collaborate with the renal transplant team and I send them for a kidney transplant with a lot of success stories. I have to say. So we offer that approach for patient on dialysis.