Abstract: FR-PO757

A Swine Model of Tunneled Dialysis Catheter (TDC) Infection and Dysfunction: Opportunities for Therapeutic Innovation

Session Information

Category: Dialysis

  • 603 Hemodialysis: Vascular Access

Authors

  • Celdran-Bonafonte, Diego, University of Arizona, Tucson, Arizona, United States
  • Campos, Begoña, University of Cincinnati, Cincinnati, Ohio, United States
  • Jarrouj, Aous, University of Arizona, Tucson, Arizona, United States
  • Wang, Li Hua, University of Arizona, Tucson, Arizona, United States
  • Kohler, Lindsay N, University of Arizona, Tucson, Arizona, United States
  • Janda, Jaroslav, University of Arizona, Tucson, Arizona, United States
  • Saum, Keith Louis, University of Cincinnati, Cincinnati, Ohio, United States
  • Brosius, Frank C., University of Arizona, Tucson, Arizona, United States
  • Roy-Chaudhury, Prabir, University of Arizona, Tucson, Arizona, United States
Background

TDC infection and dysfunction are important causes of morbidity and mortality in hemodialysis patients, with no truly effective therapies. An important reason for this is the absence of a validated large animal model. We herein describe a swine model that closely mimics the human condition.

Methods

TDC's were placed in the right jugular vein of 6 Yorkshire pigs. Blood was flushed in and out of each lumen twice weekly in order to mimic dialysis and assess for the onset of dysfunctional flow. Animals were monitored daily for infection. Blood cultures (BC) were obtained and antibiotics started when the temperature was > 103 degrees F. Animals were euthanized if they did not respond to treatment. Data on the time to infection (fever), dysfunction, and sacrifice, as also the BC profiles were collected. Data collection has been completed on 3 pigs and is ongoing in the others. We will present the available data from all 6 pigs.

Results

The average time to fever (infection) and TDC dysfunction was 9.2±5.2 and 8±6.2 days respectively. The arterial line was dysfunctional first in 83% of cases. Compacted fibrin sheaths were present in all sacrificed animals (Figure), together with jugular and central venous wall thickening. Importantly, the bacterial profile correlated with standard human data, showing growth of Klebsiella, Pseudomonas and Beta hemolytic strep (and from an earlier study Staphylococcus aureus).

Conclusion

We have, for the first time, described a large animal model of TDC infection and dysfunction which mimics the human condition. We believe that the availability of this model, with its well defined end points, will incentivize the product development pathway for novel, safe and effective therapies that target both TDC infection and dysfunction.

Funding

  • NIDDK Support