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Wilmink, Teun, Hollingworth, Lee and Dasgupta, Indranil (2016) Access ligation in transplant patients. The journal of vascular access, 17 Sup. S64-8. ISSN 1724-6032. This article is available to all HEFT staff and students via ASK HEFT Discovery tool www.heftlibrary.nhs.uk using their HEFT Athens Login.
Full text not available from this repository.Abstract
Access surgeons will encounter patients with functioning transplants who want to lose their fistula, and every dialysis unit sees patients returning after a failed kidney transplant for whom an old fistula is a readily available lifeline. The decision is straightforward in patients with perfectly functioning transplants and disabling complications of their fistula, or in patients with failing transplants and a good fistula. The challenge is to make this decision in patients with good transplant function and an asymptomatic fistula. Despite improvements in one-year survival of renal grafts, the long-term graft survival has improved modestly. This means about half of the patients with a successful kidney transplant will return to dialysis within 10 years. Use of recently developed risk calculators, based on clinical parameters, may help in the decision process. A high flow fistula can lead to heart failure but most fistulae are well tolerated in asymptomatic patients and the effects of closure of the AVF on the heart are modest. Recent evidence suggests that there may be benefits of a functioning AVF that may need to be considered in this decision process. This article reviews the literature and comes to pragmatic recommendations of what to do with this conundrum.
| Item Type: | Article |
|---|---|
| Additional Information: | This article is available to all HEFT staff and students via ASK HEFT Discovery tool www.heftlibrary.nhs.uk using their HEFT Athens Login. |
| Subjects: | WI Digestive system. Gastroenterology |
| Divisions: | Emergency Services > Renal Planned IP Care > Vascular |
| Related URLs: | |
| Depositing User: | Mrs Yolande Brookes |
| Date Deposited: | 09 Feb 2017 14:50 |
| Last Modified: | 09 Feb 2017 14:50 |
| URI: | http://www.repository.uhblibrary.co.uk/id/eprint/1177 |
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