Bovine heterografts for hemodialysis

Long-term results with 52 bovine, 53 saphenous vein and 78 radial-cephalic arteriovenous fistulas (AVF) were analyzed. Side-to-end radial-cephalic AVF provided the best patency data, and remain the preferred access system for hemodialysis. Bovine AVF were next in ranking with better patency rates than for the saphenous vein AVF studied. Corrected one-year patency rates were 71 percent for bovine, 45 percent for saphenous and 91 percent for radial-cephalic AVF. The incidence of nonthrombotic complications with bovine AVF was higher than with saphenous vein AVF. Distal ischemia due to "steal" and certain bleeding and wound complications were unique to bovine AVF. Excellent dialysis blood flow rates and easy accessibility were provided by bovine grafts. When a satisfactory radial-cephalic AVF cannot be created, bovine graft AVF is an acceptable alternative for hemodialysis access.