title: Heparin-bonded expanded polytetrafluorethylene grafts in hemodialysis access.
abstract: When options for autologous arteriovenous (AV) fistulas have been fully exhausted, AV grafts continue to play an important role in access creation for hemodialysis, offering long-term hemodialysis access that is a better alternative to central vein catheters. The drawbacks of AV grafts are their poor patency, infection and higher cost. Their main advantages are that they are widely available, are easy to create, and mature early. In the context of the "Fistula First" initiative, many patients with low quality veins suffer from fistula failure and non-maturation resulting in prolonged catheter days that would otherwise be prevented by initial creation of an AV graft. Endeavors to improve graft patency include administration of pharmacological agents, changing graft configuration, altering graft biology, and altering the graft surface. In this review, the current status of heparin-bonded AV grafts for hemodialysis is discussed.
authors.affiliation: Department of Surgery and Hemodialysis Access Center, Shaare Zedek Medical Center, Jerusalem - Israel.
authors.forename: Oded
authors.initials: O
authors.lastname: Olsha
authors.affiliation: Department of Surgery and Hemodialysis Access Center, Shaare Zedek Medical Center, Jerusalem - Israel.
authors.forename: Ilya
authors.initials: I
authors.lastname: Goldin
authors.affiliation: Department of Surgery and Hemodialysis Access Center, Shaare Zedek Medical Center, Jerusalem - Israel.
authors.forename: David
authors.initials: D
authors.lastname: Shemesh
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D002404:Catheterization; D020099:Coated Materials, Biocompatible; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000517:prevention & control; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D011677:Punctures; D006435:Renal Dialysis; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene; D006493:Heparin