[Experiences with non-human material for vascular access for long-term hemodialysis (author's transl)]

From 1975 until June 1980 a total of 115 arteriovenous fistulas were constructed in 81 patients, using non-human material for interposition. The results after implantation of human umbilical vein (n = 5) were poor because of high frequency of thrombosis, and after implantation of synthetic vascular grafts (n = 11) a high incidence of local infections had to be noted. In most patients therefore a bovine xenograft (n = 99) was used. After a follow-up of 1-48 months the calculated failure rate for the first year is 38%. The most common complication was thrombosis, with better results in curved than in straight grafts (P less than 0.05). Early thromboses were caused by a narrow anastomosis, late thromboses (after 2 months) by venous narrowing after the anastomosis. The time delay between construction and first use of the fistula had no influence on the survival rate of the fistulas. Longterm antithrombocyte medication showed better results than anticoagulation (P less than 0.05). We recommend the use of bovine xenografts for arteriovenous fistulas whenever the construction of a normal, direct arteriovenous fistula is not possible.