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Reduction of arteriovenous access blood flow in kidney transplant patients


Authors: J. Janečková;  P. Bachleda;  P. Utíkal
Authors‘ workplace: II. chirurgická klinika Fakultní nemocnice Olomouc
Published in: Rozhl. Chir., 2022, roč. 101, č. 5, s. 227-231.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2022.101.5.227–231

Overview

Introduction: Cardiovascular disease is the most frequent cause of death in kidney transplant patients. High-flow arteriovenous fistula (AVF) increases cardiac output and may contribute to hyperkinetic heart failure. AVF follow-up is not implemented in kidney transplant patients. The aim of this study was to reduce AVF blood flow in a group of patients with a high-flow AVF following kidney transplantation to reduce cardiac strain.

Methods: This prospective study was performed in kidney transplant patients who had a vascular access created before transplantation. The AVF of these patients was examined by ultrasound with a focus on AVF flow and brachial artery size. If high-flow AVF was detected, flow reduction was performed in the indicated group of patients.

Results: The study examined 164 patients, of whom 24 had a hyperfunctional AVF (14.8%). A total of 16 AVF flow reductions were performed, which led to an average decrease in cardiac index by 0.77 L/min/m2. Primary patency of the reconstructions was 93.33% after 12 months. All patients experienced a subjective improvement in dyspnea.

Conclusion: Reduction in AVF flow leads to an improvement in the quality of life of kidney transplant patients. Maintaining a functional AVF is beneficial, especially for patients after repeated surgeries, where the option of creating an autologous AVF is limited.

Keywords:

arteriovenous fistula – blood flow reduction – kidney transplant


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