The modified bovine heterograft in vascular access for chronic hemodialysis

The results of 100 modified bovine heterografts constructed in 93 patients for subcutaneous arteriovenous fistulas for chronic hemodialysis have been reviewed. Fifty-seven patients had the bovine heterograft inserted as the primary method of vascular access. Twenty-eight patients had complications consisting of graft thrombosis and stenosis, graft infection, and hemorrhage that required additional surgical procedures. Three patients with diabetes mellitus developed ischemia of the hand. Fourteen patients have died but none of the deaths could be attributable to the use of the bovine heterograft. In our experience the modified bovine heterograft has enjoyed a higher patient acceptance as compared to other methods of vascular access for hemodialysis. The chief advantage of the bovine graft has been the ability to use the graft in any patient as a means of immediate dialysis.