BMC Cancer Technical advance Intraluminal instillation of urokinase and autologous plasma: a method to unblock occluded central venous ports Georg Seifert*1, Hanno Riess2, Karl Seeger1, Guenter Henze1 and Anja Borgmann1 BioMed Central Open Access Address: 1Department of Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany and 2Department of Haematology and Oncology, Charité – Universitätsmedizin Berlin, Germany Email: Georg Seifert* - georg.seifert@charite.de; Hanno Riess - hanno.riess@charite.de; Karl Seeger - karl.seeger@charite.de; Guenter Henze - guenter.henze@charite.de; Anja Borgmann - anja.borgmann@charite.de * Corresponding author Published: 24 April 2006 BMC Cancer 2006, 6:103 doi:10.1186/1471-2407-6-103 This article is available from: http://www.biomedcentral.com/1471-2407/6/103 Received: 10 November 2005 Accepted: 24 April 2006 © 2006 Seifert et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Therapeutic use and effective function of recombinant urokinase (r-UK) for occluded ports need the presence of plasminogen. Methods: As a therapeutic proof of principle, we demonstrate that the use of r-UK and autologous plasma effectively reestablishes the function of occluded central venous ports (CVP) resistant to routine management of catheter occlusion. Five patients with occluded ports resistant to the routine management were treated. Results: All patients were successfully treated with thrombolytic therapy using intraluminal instillation of r-UK and autologous plasma. Conclusion: Instillation of r-UK and autologous plasma is a safe and effective method for management of CVP occlusion. Background Regular application of plasma products or chemotherapy is often complicated by catheter-related problems such as blockage. Especially in children, an effective and simple reestablishment of catheter patency is important. Mainte- nance of catheter function is usually achieved with flush- ing (sodium chloride and/or heparin) or urokinase instillation [1,2]. In the majority of cases low-dose uroki- nase therapy is a safe and efficacious treatment for cathe- ter occlusion, frequently obviating the need for catheter removal. However, in some cases of occluded central venous ports (CVP), r-UK instillation is not effective. Because effective therapeutic function of r-UK requires the presence of plasminogen (see Figure 1) contained in human plasma, we combined autologous plasma and r- UK for treatment of occluded CVP in adult and paediatric patients. Methods Five patients with occluded CVP were treated. Patient characteristics are given in Table 1. After up to eight attempts every 15 minutes with drawing and pressing to remove the CVP occlusion with sodium chloride and/or heparin and subsequently with 10 mg recombinant tissue plasminogen activator (r-tPA) and 5.000 IU r-UK, we used a combination of 2 ml of the patient's plasma and 10.000 IU r-UK (Medac GmbH, Germany) dissolved in 1 ml sodium chloride. The plasma was obtained by centrifuga- Page 1 of 3 (page number not for citation purposes)