Graft questions

[Rain]

As most of you know I lost my fistula 3 weeks ago.   They inserted a permacath but the hospital is pushing for me to get another access created even though I just want to be left alone for a few months.  I know have small veins and creating another fistula will be next to impossible.

Question those with a graft I have some question for you.

1.  How long have you had your graft (years)??
2. If you have had a transplant  did it clot up post transplant or is it still running strong?
3.  What problems have you had with the graft??
4. Does anyone needle themselves that have a graft?  Is there anything you need to be careful about?

I have heard that grafts don't last as long as fistulas.  but my fistula only lasted 4 years and clotted due to low blood pressure.

[Traveller1947]

Hi, Rain!  I have a graft and can answer a couple of your questions.  My graft has been going strong for almost eight years now.  In the first year, I had problems with clotting that meant visits to the interventional radiologist, who did whatever was necessary to get it going again.  No trouble since.  I have over the past year developed two pseudo aneurysms that are thin places in the graft that are ballooned out.  The potential is there for severe bleeding if someone sticks directly into the aneurysm.  I just warn the person who is sticking me about it.  I have no experience with transplant and don't needle myself, so can't help you there.  All the best to you.

[M3Riddler]

As most of you know I lost my fistula 3 weeks ago.   They inserted a permacath but the hospital is pushing for me to get another access created even though I just want to be left alone for a few months.  I know have small veins and creating another fistula will be next to impossible.

Question those with a graft I have some question for you.

1.  How long have you had your graft (years)??
2. If you have had a transplant  did it clot up post transplant or is it still running strong?
3.  What problems have you had with the graft??
4. Does anyone needle themselves that have a graft?  Is there anything you need to be careful about?

I have heard that grafts don't last as long as fistulas.  but my fistula only lasted 4 years and clotted due to low blood pressure.

Rain,
You are correct... grafts do not last as long as a fistula. The average is 18 months but there are many that have had them much longer.

If you receive a transplant, they like for you to keep your fistula as you never know what can happen.  Some of them will close off over time if not used, but I would suggest that you still monitor the fistula daily and if you notice changes to have it looked at.

Needling yourself is highly recommended. Many people fear needles but it is much better for you to learn to stick yourself than have a stranger stick you. Sticking yourself can prolong the life of your access.  Many know and have experienced infiltrations...

If you have low blood pressure, there are medications you can take to help this.  When you say you have small veins, this is a general term. Many vascular surgeons have different comfort levels.  One surgeon may say that a 4mm vein is small.  Different surgeons have different comfort levels.   Yes, the smaller the vein, the more possible the fistula will not mature, but does not mean it will happen.   There are many surgeons who are experienced with smaller veins and will create a fistula with them.   Do you know the size of your veins ?    Also the size of the vein that was used to create your current fistula?     A fistula can be created with a vein as small as 2mm... the problem is finding an experienced surgeon who will work with it. They are out there.  Many do not work on the smaller veins because it is much easier for them as a surgoen to put a graft in.  Believe it or not, some will not work on the smaller veins because it has a possibility of affected their overall success rate and just stay away from them....

Here is a great article to read.  Be sure to read the power point slides as they say a lot...

Fistula First: American Surgeons Still Last


Hope this helps...

///M3R

[Rain]

M3Riddler,

When i had my fistula i was self needling for 1 year.  I loved it.  My fistula clotted and had pseudo aneurysm that had to be removed.  I have an appointment with vascular access in 10 days so I want to make sure I understand my choices. 

I would like to get another fistula if i can instead of a graft, but at th same time I just want a couple of months with my central line to rest and relax before going for an access surgery.  I am also worried that if I get another access, I will get my call for transplant and it will never get use or have some issues..

My mother was on dialysis and she had the worst access problems that near the end she was only limited to a central line on one side since all her veins have collapsed.  I don't have to added complications that she had since I only have renal failure but she had Type 1 diabetes.  But I am so scared the same thing will happen to me and I am only 29.

[sullidog]

I have had my graft for 2 and a half years, I've had many fistulograms/fistuloplasties I can't even count, but it is still surprisingly working, and yes I have 2 tsuto aneurisms, one they tied off and one they most likely will tie it off as well.