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The management of lower limb arteriovenous grafts in the perioperative period following renal transplantation
- Source :
- Clinical Transplantation. 34
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- BACKGROUND The presence of a lower limb arteriovenous graft (LL-AVG) is indicative of a group of complex hemodialysis patients who have precarious long-term vascular access. The aim of this study is to describe our experience of the clinical decisions and interactions between LL-AVG and renal transplantation. METHODS The records of 23 patients who received a transplant in the presence of a LL-AVG between 2010 and 2018 were analyzed: firstly, to determine whether patients with a LL-AVG received extended criteria transplants, the implantation procedure, and the management of the LL-AVG in the post-operative period. RESULTS Seventeen patients (74%) had "end-stage access" and were thus considered for all offer stratified by the kidney donor profile index (KDPI) and donor type (DBD or DCD). In eleven patients (48%), a kidney with a high risk of delayed graft function was transplanted. Same-sided renal transplantation occurred in only 35% of cases, and of these, only one LL-AVG was ligated immediately to improve transplant perfusion. CONCLUSION A patient-based approach applied in decision-making on management of the LL-AVG post-transplantation should include (a) the likelihood of delayed graft function, (b) the need for post-operative hemodialysis, (c) the side of proposed transplant compared to the LL-AVG, and (d) local complications.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
030230 surgery
Expanded Criteria Donor
Lower limb
Blood Vessel Prosthesis Implantation
03 medical and health sciences
Arteriovenous Shunt, Surgical
0302 clinical medicine
Renal Dialysis
medicine
Humans
Perioperative Period
Retrospective Studies
Transplantation
Kidney
business.industry
Perioperative
Kidney Transplantation
Tissue Donors
Delayed Graft Function
Surgery
Treatment Outcome
surgical procedures, operative
medicine.anatomical_structure
Lower Extremity
030211 gastroenterology & hepatology
Hemodialysis
business
Perfusion
Subjects
Details
- ISSN :
- 13990012 and 09020063
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Clinical Transplantation
- Accession number :
- edsair.doi.dedup.....5d57529713c96cb34d7f3e35519c1f20