Fistula Care after transplant...

[carol1987]

I have a 2 year old fistula and rec'd a transplant in january...  Do you ever see your vascular doc to check the fistula after transplant?  Is there anything you need to be careful of or maintain with a fistula after transplant?? 

Do you try and keep the fistula "healthy " and usable just in case???

[Chris]

I'm thinking most don't see their vascular surgeon unless there is a problem. After I had my fistual and then graft, I never needed to see him again after post op follow up. My graft is sometimes checked by nurses and doctors to see if they still can hear a thrill, but it's not on their priority list of things to check. My thinking is to exercise your fistula with an exercise ball every now and then to keep it going, but not big enough to notice. I don't think this has been brought up in a topic befoore, so let's see what others have to say.

[willowtreewren]

During Carl's post-Tx briefing they told him that they would not do anything if his fistula should fail.

Aleta

[C904]

My fistula closed up during the transplant surgery and it was no big deal to any of the docs.  I think it is safe to say it is pretty much up to you if you want to try and keep it healthy and going.  The only tip I would give is that if the fistula shuts down to still avoid having blood drawn from that main vein higher up your arm where they do blood draws from.  When the fistula shuts down the blood is still raging down that vein it just diverts once it hits the closed fistula.  This might just be common sense to people who have a fistula, but I was thinking it is fine to hit that vein during blood draws because the fistula is closed.  With the blood still raging down that vein I had problems on two different occasions of having the blood pool up where they did the blood draw from.

[bette1]

I was told to follow the previous instructions;  don't carry over 10 lbs on that arm, don't sleep on that arm, don't let anyone take blood from that arm, etc.  My doc said that it's your insurance in case something happens to your transplant.

[okarol]

Jenna's fistula failed on the day of her transplant. They did not attempt to rescue it as they did not want to risk any infection with a new kidney.
If you feel the "thrill" and it seems same as always, I think you can do as mentioned, to protect it.
If the sounds gets weak, or you notice any symptoms of a blockage, I'd see a vascular doctor to evaluate it. Here's more info http://ihatedialysis.com/forum/index.php?topic=4287.0
Have you read about Meinuk's fistula removal? There is good info that you might need later down the road. http://ihatedialysis.com/forum/index.php?topic=18735.0

[lawphi]

We were told it would eventually fail.  A good friend lost his fistula two years post transplant.

His buttonholes are already gone.

[Chris]

don't let anyone take blood from that arm, etc. 

I was told that also, but already knew that from dialysis. They will not take blood from any part of that arm here.

[staceyand joe92]

My fistula was HUGE and became very achy after my transplant. At about 6 months post transplant my neph and vascular surg thought it was best to remove it comptletely. I didn't give it a second thought. It was more dangereous to keep it than to  chance I may need it later in life.

[sullidog]

I've heard that a lot of them do fail after transplant. I know someone also if you grab him by that area it will hurt. This same friend, his fistula, you can't fill a thrill anymore but he still has a bit of bruit.

[RichardMEL]

mine is still going strong six months post. Sometimes in clinic the docs feel the thrill, but don't really give it much attention. At one time one of the senior guys did say "maybe after a year we'll think about doing something about that" but he was a bit vague about what exactly that meant.

I think when it's still relatively early days and it's still working it's great to have that "standby" there just in case the very worst happens.

I just treat it as normal like others have said - I don't allow BP's on it, I don't have blood taken from that arm etc and don't lift anything too heavy but basically I ignore it. every other day I feel for the thrill but understand that if it does fail it's not the end of the world and just report it at next clinic rather than rush to ER if I was still needing it for D.

Hoping I won't need to use it anytime soon!!!

[rsudock]

The fistula I use now is the same one I had 10 years during my previous transplant. Mine never slowed down, but did get stronger after I started dialysis for the first time. Like others have said no BPs, blood draws, and do not sleep on it. Even after transplant number 2 I will still try and protect it.

xo,
R

[carol1987]

Thanks everyone!!!   

[monrein]

Mine is still going strong more than 2 years post-transplant.  First one clotted off several months after first trx.  I saw my vascular surgeon because I thought it was big and might cause problems but he thought it looked "fantastic" and said not to worry.  No BPs, bloods etc and I'm pretty protective overall.  The worst thing is I never wear shorter than elbow length sleeves...so if that's the worst thing, who cares!

[carol1987]

Monrein... Mine is on my lower arm   and I have a huge scar also from surgery to raise the fistula..  This will be my first summer with it so we shall see if I get stares or comments...

I have been continuing to follow the no BP or bloods... I went thru a lot to get the fistula so I want to protect it as much as possible..