Universität zu Köln

Matoussevitch, Vladimir, Taylan, Christina, Konner, Klaus, Gawenda, Michael, Kuhr, Kathrin, Hoppe, Bernd and Brunkwall, Jan (2015). AV fistula creation in paediatric patients: outcome is independent of demographics and fistula type reducing usage of venous catheters. J. Vasc. Access, 16 (5). S. 382 - 388. LONDON: SAGE PUBLICATIONS LTD. ISSN 1724-6032

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Abstract

Purpose: Even though early transplantation is still the first-line therapy in paediatric patients with end-stage renal disease (ESRD), up to 30% of these patients still require haemodialysis (HD). Creating an arteriovenous fistula (AVF) is quite challenging, particularly in children, leading to disproportional use of catheters. In this paper, we describe our experience in the creation of AVF with currently no in-dwelling catheters in children and adolescents on HD. Methods: From January 2009 to December 2013, there were 34 patients rated as unfit for transplantation for at least the next 6 months or who had already been on HD through a central venous catheter (CVC). Three patients aged between 12 months and 3 years and weighing 9-12 kg were not suitable for AVF. Finally 31 patients, from 6 to 19 years of age with a mean weight of 43.3 +/- 14.5 kg (19-80 kg), were assigned to the alternative of AVF. Results: During the above-mentioned time period, 31 patients were provided with 32 AVFs; 26 received a distal radiocephalic fistula, five a Gracz-type fistula and one a brachio-basilic fistula. All but two fistulae matured primarily, within an average time of 45 (range: 16-191) days until the first dialysis. The fistula's 1-year primary and primary assisted patency rates were 78% and 94%, respectively. Conclusions: The creation of a native vascular access is an effective and durable procedure in paediatric and adolescent patients. It reduces using of CVCs and is appropriate both for long-term treatment and as a bridging procedure until renal transplantation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Matoussevitch, Vladimir UNSPECIFIED UNSPECIFIED UNSPECIFIED Taylan, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Konner, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Gawenda, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhr, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoppe, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-393605
DOI:	10.5301/jva.5000395
Journal or Publication Title:	J. Vasc. Access
Volume:	16
Number:	5
Page Range:	S. 382 - 388
Date:	2015
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	1724-6032
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VASCULAR ACCESS SURVIVAL; ARTERIOVENOUS-FISTULAS; CHRONIC-HEMODIALYSIS; CHILDREN; COMPLICATIONS; MICROSURGERY Multiple languages Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39360