Allogenous vein graft as vascular access for hemodialysis - lost battle?

Purpose: The purpose of this paper is to assess a long-term outcome of allogenous vein grafts (ALVG) as vascular access for hemodialysis. Materials and methods: For nearly eight years (between 9/2002 and 9/2011) a total of 78 patients with 112 ALVGs were involved in the study. The register included 46 women and 32 men, mean age 66.1 +/- 11.2 years; range 20-88 years. The patient database was retrospectively reviewed and statistical processing was performed. Results: Almost all ALVGs were treated by PTA or surgically, very often repeatedly. The number of radiologic interventions was 316, the number of surgical procedures 31. Mean follow-up time was 795 days, range 28-3522 days. Thirty-five patients died of unrelated causes, nineteen with functional graft, fourteen patients were lost to follow-up. Forty ALVGs failed for various reasons, mostly because of occlusion. Only one patient underwent successful renal transplantation, no patient converted to peritoneal dialysis. Thirty-seven ALVGs remain correctly functioning. Primary patency rates at 6, 12, and 24 months were 81 +/- 5%, 63 +/- 5%, and 34 +/- 2% respectively. Secondary patency rates at 6, 12, and 24 months were 96 +/- 2%, 82 +/- 4%, and 65 +/- 5% respectively. Conclusions: Allogenous vein grafts, in spite of the high number of necessary radiologic and surgical interventions and reinterventions, show acceptable clinical usability and durability, comparable with other types of prosthetic grafts.