title: The LifeSite Hemodialysis Access System in patients with limited access.
abstract: OBJECTIVE
  The LifeSite Hemodialysis Access System was recently introduced as a completely subcutaneous device with reported advantages of improved patient comfort and reduced catheter-related infection. The performance of the LifeSite catheter at a single, tertiary-care university medical center was reviewed.
  
  
  METHODS
  We retrospectively reviewed all patients who underwent placement of the LifeSite catheter between February 2001 and March 2002. Kaplan-Meier analysis was used to determine the probability of patient survival, freedom from catheter-related infection, and freedom from device failure necessitating catheter removal.
  
  
  RESULTS
  Thirty-six patients who had previously received dialysis for an average of 6.1 years underwent placement of 37 LifeSite catheters. Most patients (95%) were referred for LifeSite placement because they had exhausted all available arteriovenous fistula and graft sites. Mean follow-up was 6.8 months, with a patient survival rate of 81% at 8 months. Primary and secondary patency rates were 62% and 87% at 8 months, respectively. Two patients died from infectious device-related complications. Twelve of 17 patients (71%) with device-related infection did not manifest any signs or symptoms at the valve site. There were 2.4 catheter-related infections and 2.6 device failures requiring removal per 1000 patient-catheter days. Freedom from infection and device removal at 8 months was 46% and 49%, respectively.
  
  
  CONCLUSIONS
  The LifeSite demonstrated acceptable patency, infection, and device failure rates; however, in patients with limited access, unrecognized infection and death may occur. The LifeSite should not be used as a substitute for a more permanent form of hemodialysis access.
authors.affiliation: Division of Vascular Surgery, School of Medicine, Emory University, Atlanta, GA 30322, USA.
authors.forename: Sunil S
authors.initials: SS
authors.lastname: Rayan
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Terramani
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Weiss
authors.forename: Elliot L
authors.initials: EL
authors.lastname: Chaikof
mesh_terms: D001424:Bacterial Infections / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*; D012189:Retrospective Studies; D015996:Survival Rate