Preserved Allografts of Dilated Saphenous Vein for Vascular Access in Hemodialysis

Abstract

Arteriovenous fistulas constructed from preserved (frozen) allograft veins provided vascular access for maintenance hemodialysis in 14 patients with inadequate vasculature for conventional autogenous fistulas. Electromagnetic flows ranged from 200 to 250 cc/min. Dialysis flows of 200 cc/min were accomplished consistently. The allografts were useable for dialysis much earlier than autogenous A-V fistulas. Arteriography demonstrated a wide vasculature channel very suitable for dialysis needles. Allografts seemed superior to bovine heterografts in both patency and susceptibility to infection. Scanning electron microscopy revealed smoother intimal surfaces if the donor received small amounts of heparin systemically while the veins were being removed. Allograft veins appear to be a useful alternative means of vascular access for hemodialysis.