title: The pros and cons of preserving a functioning arteriovenous fistula after kidney transplantation.
abstract: The autologous arteriovenous fistula (AVF) for hemodialysis burdens the cardiovascular system with increased cardiac output and pulmonary artery pressure, increasing cardiovascular risk. This article reviews literature on the benefits and drawbacks of a functioning AVF after kidney transplantation and discusses the cardiovascular effects of AVF closure. Several cohort studies demonstrate a significant cardiac burden of an AVF and improvement of cardiac dimensions after AVF ligation. However, no randomized trials have been conducted on routine AVF closure after successful kidney transplantation. Therefore, clinical trials are warranted to evaluate whether the cardiovascular benefits of routine AVF closure outweigh the potential harm for patients after successful kidney transplantation.
authors.affiliation: Department of Nephrology, Leiden University Medical Center, Leiden - The Netherlands.
authors.forename: Bram M
authors.initials: BM
authors.lastname: Voorzaat
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden - The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: van Schaik
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden - The Netherlands.
authors.forename: Hans-Marc J
authors.initials: HM
authors.lastname: Siebelink
authors.affiliation: Department of Surgery, Maastricht University Medical Center, Maastricht - The Netherlands.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Tordoir
authors.affiliation: Department of Nephrology, Leiden University Medical Center, Leiden - The Netherlands.
authors.forename: Joris I
authors.initials: JI
authors.lastname: Rotmans
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D006439:Hemodynamics; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects; D008026:Ligation; D020127:Recovery of Function; D006435:Renal Dialysis; D012307:Risk Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left