Any one on graph for hemo

[Seaweed]

Hi all. I had to switch to in home hemo
But i believe Dr wants to put a graph
Is there anyone out there that has one

[Simon Dog]

Do you mean graft?

[Michael Murphy]

Yes it’s the safest form of access fit hemo. It’s commonly referred to as a fistula.  A vascular surgeon takes a vien and artery and connects them. I have had one fo 10 years now.

[kitkatz]

There are three types of access for dialysis.

Chest catheter with tubes that go in and out of you chest that are used for dialysis.

A graft is a bovine or plastic piece that connects an artery and vein. It can be used with 2 to 4 weeks after the arm has healed.

A fistula is an vein connected to an artery to make it large enough to do dialysis.  A fistula requires time to develop usually 6-8 weeks or more are needed until the fistula has matured enough to use.

Clarify these things with your doctor.

[Simon Dog]

Grafts are generally a second choice to fistulas, as they have a limited life of 2 years +/-.   I used a fistula for 6 years and its still buzzing away 2 years after transplant.

You always enter a graft with the needle at a 45deg angle.  That was the only question I had to guess on on the home hemo test, and they didn't bother mentioning that point in the training since I had a fistula - which is probably why I will always remember this detail.

There are other types beside the three - femoral line (temporary); various leg fistulas (or is is fustulii?); necklace fistula (obscure and complex, never saw one of these)

If a graft is recommended, ask why you are not suitable for a regular fistula.

[UkrainianTracksuit]

Yes, I did dialysis for a short time with a arteriovenous graft if that is what you mean. I struggled with the creation of a good fistula (finally got a good one buzzing away), but like said above, it was able to be used quickly. And like previously said, it didn't last too long, in comparison to a fistula. That's all that there is to say, I guess.

[kristina]

Grafts are generally a second choice to fistulas, as they have a limited life of 2 years +/-.   I used a fistula for 6 years and its still buzzing away 2 years after transplant.

Hello Simon,
Please tell me : How come that your fistula is still "buzzing away" two years after your successful transplant? Did the medics "keep it in" just in case because your new kidney did not "come up to scratch" yet or is it a usual procedure? I am only asking because my dialysis-chest-access was "taken out" very shortly after my own transplant.
Many thanks for your answer from Kristina.

[UkrainianTracksuit]

Hi Kristina, I won’t speak for Simon Dog, and I'm sure he'll give a much better and personalized answer than this. But, I can explain as I have a similar situation to you.



Shortly after transplant, my chest catheter was removed too. Once numbers are stabilized, there is really no need to have a foreign object still protruding from your body. Add in the fact that it hinders basic activities of a normal life due to the risk of infection (which thus augments on immune-suppressive drugs), it comes out as soon as possible. It is not needed with a working transplant and can be easily installed yet again for a (hopefully not needed) next time.



A fistula is completely different. Yes, it is usual to leave one alone. It is created inside the body and you can’t just go in and remove it. It’s a fusion of an artery and a vein. If it doesn’t cause any problems, there isn’t a need to see a vascular surgeon to tie it off. Add in the fact that a good working fistula may have to come into the use for the future, it is best to leave it alone. Transplanted kidneys don’t last forever after all and having a dialysis access in such a future case is beneficial.



I have a fistula that is still buzzing away too.

[kristina]

Many thanks for your kind explanation, Ukrainian Tracksuit, it is very much appreciated. I remember when I had my chest-catheter finally removed, I was totally relieved and also very grateful, that it went well.
Take care and thanks again from Kristina.

[Simon Dog]

Hello Simon,
Please tell me : How come that your fistula is still "buzzing away" two years after your successful transplant? Did the medics "keep it in" just in case because your new kidney did not "come up to scratch" yet or is it a usual procedure? I am only asking because my dialysis-chest-access was "taken out" very shortly after my own transplant.
Many thanks for your answer from Kristina.

UKTS said most of it.

There are some studies that suggest it ie better for cardiac health to remove the fistula, however, that is far from a universal practice.

If a fistula is removed that site cannot be re-used.   One dialysis challenge is some patients can go a long time on a single fistula, whereas others burn through them in relatively short order.  Eventually the surgeons run out of places to put a new one and move to the leg or necklace graft fistula.  By leaving a fisutla that works in a transplant patient, the patient does not use up one of the limited fistulizable locations in the event dialysis once again rears its ugly head.

I just signed on to buy a condo so I have a place to send my wife if I go back on D and she can't stand the machine.  In the meantime, we will use it for weekend getaways.