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Human umbilical vein for vascular access in chronic hemodialysis
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Human umbilical vein grafts provide a viable vascular access for hemodialysis in chronic renal failure patients. Despite complications like infection and thrombosis, these grafts offer a functional option when other methods fail.
Area of Science:
- Vascular Surgery
- Nephrology
- Biomaterials
Background:
- Chronic renal failure necessitates reliable vascular access for hemodialysis.
- Conventional vascular access methods (e.g., arteriovenous fistulas) may not always be feasible.
- Human umbilical vein grafts (HUVS) have been utilized as an alternative access method since 1979.
Purpose of the Study:
- To evaluate the efficacy and complications of human umbilical vein grafts for hemodialysis access.
- To determine the long-term function and patency rates of HUVS in patients with end-stage renal disease.
Main Methods:
- A retrospective analysis of 33 HUVS fistulas implanted in 24 patients undergoing hemodialysis.
- Documentation of implantation, complications (infection, thrombosis, aneurysm, stenosis), interventions, and graft survival.
- Assessment of functional duration and patency rates.
Main Results:
- A median graft function time of 8.5 months was achieved in 26 utilized grafts.
- Complications included infection (7/33 grafts, all removed), thrombosis (25/33 grafts, 5 lost, 20 successful thrombectomies), aneurysm (4/33 grafts, 2 lost), and stenosis (3/33 grafts, 1 lost).
- At study end, 10 grafts remained open, with 8 actively used for hemodialysis.
Conclusions:
- Human umbilical vein grafts represent an acceptable vascular access option for hemodialysis.
- HUVS can provide functional access, particularly when standard fistula creation methods are exhausted.
- Careful monitoring is required due to potential complications such as infection and thrombosis.
Abstract:
Since 1979 we have used human umbilical vein graft as the ultimate vascular access for hemodialysis in patients with chronic renal failure. In 24 patients 33 graft fistulas were performed. Several complications were encountered. Among these infection was the most serious, occurring in seven grafts. All these grafts were removed and never used for hemodialysis. Thrombosis occurred 25 times, and five grafts were lost because of this, whereas 20 grafts had successful thrombectomy and continued to function. Aneurysm formation occurred four times, two grafts were lost. Stenosis was seen in three cases, one graft was lost. In the material 26 grafts were used for hemodialysis and a median function time of 8.5 months was obtained. At the end of the observation period 10 grafts were open, eight were used for hemodialysis, two were not used because of successful transplantation. The umbilical vein graft is an acceptable alternative as vascular access where conventional methods of fistula formation have been exhausted.