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Author Topic: Graft placement in upper leg ?  (Read 2595 times)
Katonsdad
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« on: February 22, 2012, 09:01:41 PM »
Okay , So my graft in my arm has clotted for the second time in a week.  Lucky me ,  Off to the vascular surgeon for
a cath in my chest.  Make me look like Frankenstein. I hate it.   My graft is in my upper left arm but also extends down
to my elbow.  I think that is the problem . When  I bend my arm  (ie while sleeping) it cuts off the
blood supply
I am thinking about having them place the new graft in my upper leg.  Anyone else doing this?

Katonsdad
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Diabetes 1976
Eye issues 1987
Kidney Failure 1997
CAPD 1997 , Stopped 1997 due to infections evey 28 days
Started In Center Hemo 1997
Received Kidney/Pancreas transplant 1999 at UCLA
Wife and I had son in 2001 , by donor for my part (Stopping the illness train)
Kidney failed 2011 , Back on Hemo . Looking to retransplant as the Kidney is still working



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Hemodoc
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« Reply #1 on: February 22, 2012, 09:45:58 PM »
If you already have a working access, whether ideal or not, I seriously doubt a surgeon will look at the leg. I had one patient while I was still practicing in internal medicine who ran out of access sites and had a right upper thigh graft placed. She suffered repeated infections from this graft which is one of the issues with leg grafts. She ended up having a permanent catheter for the last several years on dialysis. I believe she lived a total of 11 years on dialysis, the last 1-2 years on home hemodialysis with NxStage.

The short answer is the leg is only a last resort placement and can be very problematic. I knew another patient who ran out of access and they placed it in his abdomen. There are even accesses in the chest as well, but these are last resort placements done by specialty vascular surgeons in medical school centers usually.
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Peter Laird, MD
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Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
sullidog
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« Reply #2 on: February 26, 2012, 05:25:24 PM »
my v surgeon will only do this as a last resort do to the unsanatary conditions, also someone from my center had one and had lots of issues with it, what I don't know.
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
Rerun
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« Reply #3 on: February 27, 2012, 12:32:01 PM »
That is probably what is next for me.  My left arm fistula is wearing out and my right arm fistula needs to be brought up to the surface but they are not sure it will work.  But, I have to have some access so they can repair the left fistula.  They are looking at my leg.  My chest has had too many catheters so can't go there.   Ugggh.  What do you do but keep trying.  Also having two working fistulas is hard on the heart.  Oh joy!

          :flower;    There is a girl at my center that has one and she said she has no problem.
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