AUTHOR=Janeckova Jana , Bachleda Petr , Utikal Petr , Orsag Jirir 

TITLE=Management of Arteriovenous Fistula After Successful Kidney Transplantation in Long-Term Follow-Up

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12841

DOI=10.3389/ti.2024.12841

ISSN=1432-2277

ABSTRACT=Arteriovenous fistula (AVF) is the best method of vascular access for hemodialysis. This approach may lead to several complications, such as hyperkinetic heart failure due to a hyperfunctional AVF or feeding artery dilatation. These are late complications, especially in patients after a successful kidney transplantation. An observational study was performed focusing on patients more than 12 months after a kidney transplantation. The AVF was examined by ultrasound, if outflow exceeded 1.5 L/min, an echocardiogram was performed. Surgical management was indicated if the cardiac index was higher than 3.9 L/min/m 2 or upon finding a brachial artery aneurysm. A total of 208 patients after kidney transplantation were examined over the period of 3 years, from which 46 patients (22.11%) had a hyperfunctional AVF and 34 cases (16.34%) of feeding artery dilatation were determined. 40 AVF flow reduction and 6 AVF ligation procedures were performed. Median AVF flow before and after the reduction was 2.955 ml/min and 1.060 ml/min, respectively. Primary patency after flow reduction was 88.3% at 12 months. Late AVF complications in patients following kidney transplantation are quite common. It is necessary to create a screening programme to monitor AVFs in these patients.