title: Assessment of apoptosis in the native vein used for hemodialysis access.
abstract: OBJECTIVE
  To determine whether apoptosis is more common in previously punctured native veins than in non-punctured native veins among patients who undergo surgical creation of arteriovenous fistula (AVF) for dialysis access.
  
  
  METHODS
  Cephalic vein specimens were obtained from January 1, 2013 to December 31, 2014 from 60 patients, 30 with previously punctured native veins and 30 with non-punctured native veins. Before AVF placement, a 1-cm vein segment was excised from distal part of the vein for histological, histochemical, and immunohistochemical analysis. Vein specimens were divided into two portions along the longitudinal axis and stained with hematoxylin and eosin for routine histological evaluation. Immunohistochemical analysis was used to localize Bax, p53, caspase 3, and Bcl-2 expression.
  
  
  RESULTS
  The group with previously punctured veins showed significantly increased caspase 3 (P<0.001, two-sided Fisher`s Exact Test) and Bax expression (P=0.002, two-sided Fisher`s Exact Test) and significantly decreased Bcl-2 expression (P<0.001, two-sided Fisher`s Exact Test) compared with the control group. There were no significant differences between the groups in p53 expression (?2=0.071, df=1, P=0.791). Fistula failure was significantly more common in the study group (26.7% vs 6.7%, ?2=4.32, df=1, P=0.038).
  
  
  CONCLUSIONS
  Our study indicates a possible role of venipuncture in apoptosis development and a possible role of apoptosis in fistula failure, but we do not have sufficient evidence to conclude that it represents its main cause.
authors.affiliation: Laura Leci-Tahiri, Clinic of Vascular Surgery, University Clinical Center of Kosovo, 10000 Prishtina, Kosovo, lauraleci@yahoo.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Leci-Tahiri
authors.forename: Božo
authors.initials: B
authors.lastname: Krušlin
authors.forename: Majda
authors.initials: M
authors.lastname: Vučić
authors.forename: Zdenko
authors.initials: Z
authors.lastname: Sonicki
authors.forename: Ivo
authors.initials: I
authors.lastname: Lovričević
mesh_terms: D017209:Apoptosis / Q000276:immunology / Q000502:physiology*; D001166:Arteriovenous Shunt, Surgical; D053148:Caspase 3 / Q000096:biosynthesis; D006801:Humans; D011677:Punctures; D006435:Renal Dialysis; D013997:Time Factors; D014680:Veins / Q000503:physiopathology*
chemical_list: D053148:Caspase 3