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Related Experiment Video

Updated: Mar 24, 2026

Murine Full-thickness Skin Transplantation
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Access ligation in transplant patients.

Teun Wilmink1, Lee Hollingworth2, Indranil Dasgupta2

  • 1Department of Vascular Surgery, Heart of England NHS Foundation Trust, Birmingham - UK.

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|March 9, 2016
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Summary

For kidney transplant recipients with an asymptomatic arteriovenous fistula (AVF), the decision to close it is complex. Long-term transplant survival rates suggest many may need the AVF again, impacting closure recommendations.

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Transplant Surgery

Background:

  • Access surgeons and dialysis units manage patients with arteriovenous fistulas (AVFs) in the context of kidney transplantation.
  • Decisions regarding AVF closure are complicated by varying transplant function and fistula status.

Purpose of the Study:

  • To review the literature and provide pragmatic recommendations for managing asymptomatic AVFs in kidney transplant recipients.
  • To address the dilemma of AVF closure versus preservation in patients with well-functioning transplants.

Main Methods:

  • Literature review of studies on AVF management, kidney transplant outcomes, and cardiovascular effects.
  • Analysis of risk calculators and clinical parameters to aid decision-making.

Main Results:

  • Long-term kidney graft survival remains a concern, with approximately 50% of patients returning to dialysis within 10 years.
  • High-flow AVFs can cause heart failure, but most are well-tolerated in asymptomatic patients with modest cardiac effects upon closure.
  • Emerging evidence suggests potential benefits of maintaining a functioning AVF.

Conclusions:

  • The decision to close an asymptomatic AVF in a kidney transplant recipient requires careful consideration of long-term graft survival and potential AVF benefits.
  • Risk calculators may assist in this complex clinical decision-making process.