Evaluation Background: Closed-System Transfer Devices

January 25, 2023 | Evaluations & Guidance


Here's background for our Evaluations of closed-system transfer devices, outlining the key considerations for making wise purchasing decisions. Learn how the technology is used and what factors we test for. Also review our latest product ratings and ECRI's data describing hospitals' interest in each vendor.

Closed-system transfer devices (CSTDs) are adapters that connect two medication vessels—vials, syringes, or IV bags—to allow hazardous drugs (HDs) to be transferred between the vessels without leakage. They are used to minimize personnel environmental exposure to HDs from the time the drugs are compounded in the pharmacy to the time they are administered to the patient.

In the pharmacy, CSTDs are typically used with syringes for accessing medication vials and IV bags for medication and fluid transfers that occur during the compounding process. In clinical areas, an HD can be connected to an administration set via a CSTD adapter that enables patient line connections without compromising the closed system.

CSTDs are a developing technology, and manufacturers regularly bring new solutions to market. Manufacturers also continue to add components that minimize the chance of incorrect disconnections and that ensure compatibility with different HD use cases; for example, ICU Medical offers a ChemoLock CSTD kit for use with Bacillus Calmette-Guerin (BCG) immunotherapy. It is advantageous for the manufacturer to provide CSTD access for niche use cases. These developments can help protect personnel who handle HDs, while minimizing the impact on workflow.

Major product components include the following:

  1. CSTD...

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