Activase is used to break up a fibrin clot in the PD catheter. Our practice is to reconstitute 8 mgs of Activase in 10 ccs of saline. Using sterile technique, remove the mini cap (or other catheter cap), attach the syringe and gently inject the whole 10ccs. Replace catheter cap. Dwell for 1 hour, then attempt to drain. You can do this by attaching an exchange set- do not aspirate with a syringe. If the abdomen has been empty, try doing a quick, 100 ml in and out flush before attempting a whole exchange. Don’t worry about any activase that gets in the abdomen, the half life is only about 14 minutes and the amount is small and not systemically absorbed. Repeat x 1, but if still no success, investigate other reasons for malfunction.

Sometimes we send a patient home with activase dwelling in the catheter until their next exchange or start of cycler treatment.

I hope this was helpful- I was first author on the article in the ANNA journal on this subject a few years ago.