[Natural history of vascular ports for hemodialysis after renal transplantation].
BACKGROUND
The objective of this study was to assess the long-term outcome of AV shunts in renal transplant recipients, to discuss mechanisms affecting their functioning and the surgical strategy designed to optimally preserve the venous capital in the hypothesis of a return to dialysis.


METHODS
160 renal transplant recipients, with a mean age of 47 years, were reviewed. AV shunts were performed at the wrist in 95% of cases and in the cubital fossa in 13% of cases. The AV shunt had been performed an average of 29 months before renal transplantation.


RESULTS
62% of AV shunts were considered to be functional with a mean follow-up of 69 months after transplantation and 95 months after creation. The intraoperative and early and late postoperative thrombosis rates were 6%, 7.5% and 17%, respectively. The AV shunt was subsequently closed in 12 patients (7.5%).


CONCLUSIONS
Native distal AV shunts, although not used after renal transplantation, have a prolonged survival. The main risk is thrombosis which can be prevented intraoperative and perioperatively. These results encourage a conservative attitude to all well tolerated AV shunts.
Bensalah
K
K
Service d'Urologie, Hôpital Pontchaillou, Rennes, France.
Guillé
F
F
Rivalan
J
J
Joyeux
V
V
Gié
S
S
Laruelle
E
E
Garry
J
J
Morin
M P
MP
Le Pogamp
P
P
Lobel
B
B
Patard
J J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D006435:Renal Dialysis