title: Multi-center experience of 164 consecutive Hemodialysis Reliable Outflow [HeRO] graft implants for hemodialysis treatment.
abstract: OBJECTIVE
  To report a multi-center experience with the novel Hemodialysis Reliable Outflow (HeRO) vascular access graft.
  
  
  METHODS
  Four centers conducted a retrospective review of end stage renal disease patients who received the HeRO device from implant to last available follow-up. Data is available on 164 patients with an accumulated 2092.1 HeRO implant months.
  
  
  RESULTS
  At 6 months, HeRO primary and secondary patency is 60% and 90.8%, respectively and at 12 months, 48.8% and 90.8%, respectively. At 24 months, HeRO had a primary patency of 42.9% and secondary patency was 86.7%. Interventions to maintain or re-establish patency have been required in 71.3% of patients (117/164) resulting in an intervention rate of 1.5/year. Access related infections have been reported in 4.3% patients resulting in a rate of 0.14/1000 implant days.
  
  
  CONCLUSIONS
  In our experience the HeRO device has performed comparably to standard AVGs and has proven superior to TDCs in terms of patency, intervention, and infection rates when compared to the peer-reviewed literature. As an alternative to catheter dependence as a means for hemodialysis access, this graft could reduce the morbidity and mortality associated with TDCs and have a profound impact on the costs associated with catheter related infections and interventions.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Duke University, Durham, NC 27710, USA. shawn.gage@duke.edu
authors.forename: S M
authors.initials: SM
authors.lastname: Gage
authors.forename: H E
authors.initials: HE
authors.lastname: Katzman
authors.forename: J R
authors.initials: JR
authors.lastname: Ross
authors.forename: S E
authors.initials: SE
authors.lastname: Hohmann
authors.forename: C A
authors.initials: CA
authors.lastname: Sharpe
authors.forename: D W
authors.initials: DW
authors.lastname: Butterly
authors.forename: J H
authors.initials: JH
authors.lastname: Lawson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D002408:Catheters, Indwelling; D019544:Equipment Failure Analysis / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D006435:Renal Dialysis / Q000295:instrumentation*; D012189:Retrospective Studies; D055815:Young Adult