© 1997 Andrew Lundin, M.D. All rights reserved.
Reproduced with permission.
Is it feasible or desirable for a person who has a graft
grow a fistula?
A native (Cimino-Brescia - named after the doctors who first
did one in
1966) fistula is, without doubt, the best HD access. Mine
constructed by a master craftsman and is still working 29 years
surviving 5.5 years of a transplant. Others have described a
experience. After the transplant the surgeons offered to close
fistula. Their trust in the permanence of cadaveric transplants
stronger than mine.
As to the question, if you can get a fistula use the graft
fistula is developing then lose the graft.
Not all surgeons are created equal in their ability to make
fistulas. This is one area where word-of-mouth or a shoppers'
well worth the effort.
Would it have to be on the other arm?
Generally, but would let the surgeon make the
judgement.Would the button hole technique be good for a person with a
graft or would it not matter?
I have used the button-hole technique for most of the 29 years
have had the fistula. Three arterial spots and three venous
rotated during the week. If I were to do daily dialysis, I
could find a
few more pairings.
I think the button-hole technique would be a problem with
of the artificial material that would not heal like real
tissue. In fact
I suspect the hole would just get bigger with time causing loss
of the graft.
Peter Lundin, M.D.
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