Fistula vs. Graft, etc.

[peleroja]

Well, since I can no longer do PD, I suppose I'd better start asking some questions.  Which is better, graft or fistula?  How long does each take to mature?  Does one last longer than another?  All your thoughts and opinions, please.

[jbeany]

Fistula is better.  A graft is for those of us with garbage veins who don't have enough of them to string together to make a fistula.  Fistulas are self-healing.  Grafts are gore-tex artificial tubes that eventually get so many punctures that they are no longer usable.

They will map your veins to figure out what you have to have.

[M3Riddler]

Well, since I can no longer do PD, I suppose I'd better start asking some questions.  Which is better, graft or fistula?  How long does each take to mature?  Does one last longer than another?  All your thoughts and opinions, please.

Pelejoja,

A fistula should be your first choice. The fisutula is composed of a vein and artery which are natural of your body.  A graph is composed of synthetic material and will not last anywhere near as long as your own veins.

One thing to remember when you get your veins mapped for the fistula, make sure an experienced person is doing the procedure.  Ask the size of your veins. If they will not tell you while doing the procedure, let them know that you would like a copy of the procedure. They should have no problem putting this on cd for you. This is good to keep foryour records. There will also be a report attached that will tell you everything about your veins down to the size etc...  Make sure they really interogate your veins on both arms.  Some centers use a tourniquet while doing the vein study while others do not.

Number two is that ask the vascular surgeon you see what level of vein size they are comfortable with. Some surgeons are not comfortable  creating a fistula where your veins are below a certain size.  You would be suprised how the criteria changes from surgeon to surgeon.  Dont be afraid to get a second opinioin.

Do you have any specific questions ?

///M3R

[ODAT]

I have some info in a college paper. It's in General Discussion page 10 - Kidney Dialysis: Access for Life. It may answer some questions.

[Stoday]

When I was about to get my fistula I asked the surgeon about vein mapping. He told me it was only done when it was necessary. It wasn't necessary for me because he could see that my veins were adequate. If you are told that you won't be getting a vein map, then that's probably a good thing.

On the other hand, I can understand that vein mapping is de jure in the USA where there is a financial incentive to undertake the procedure.