Transplantation and Surgical Immunology – Vascular Access

The surgeons in our transplant division are experts in solving problems that arise with dialysis access.

The types of services our surgeons provide include:

  • Arteriovenous fistula and graft placement
  • Revision of fistulas or grafts
  • Fistulograms
  • Endovascular angioplasty
  • Peritoneal dialysis catheter placement and management
  • Dialysis access ultrasound
  • HeRo access placement and management
  • Care of complicated vascular access problems

Our general surgical services include:

  • Hernia Repair in Peritoneal Dialysis Patients
  • Parathyroidectomy in End Stage Renal Disease Patients
  • Robotic Hernia Repair
  • Hernia Repair in Patients with Cirrhosis

Dialysis Options

Kidney function is essential for life. End Stage Renal Disease (ESRD) can be treated with either dialysis or a renal transplant. Our transplant division has expertise in replacement therapy for ESRD. There are two options for dialysis:

  • Peritoneal Dialysis: This therapy places a cleaning solution into the peritoneum via a soft plastic catheter which is placed into the abdomen and stays. This solution cleans the blood. The solution can be instilled at night and at home. This gives the patient more freedom to carry on daily activities.
  • Hemodialysis: This therapy requires access to blood. The blood leaves the body in a tube, is cleansed and then returned to the body. The access is obtained via a catheter placed into major vessels in the neck or groin. The ideal vascular access for hemodialysis is a fistula (using the veins in the arm) or placing a graft (a plastic material which is placed under the skin). Both the fistula and the graft require surgery.

Maintenance of Access

Over time hemodialysis access can become clotted or require other attention, and peritoneal access catheters may require attention. Our transplant division has the expertise to solve these problems.

What Patients Should Know

Patients should set up a vascular access well before starting hemodialysis, as AV fistulas and AV grafts both need time to mature before they are ready for use. A health care provider can help schedule an appointment well before the patient starts hemodialysis or Peritoneal Dialysis, even if the patient is feeling fine. Giving a vascular access time to mature can help prevent problems with narrowed veins, low blood flow, and blood clots.

We offer all types of Vascular Access and Peritoneal Dialysis Access for our patients. Please call (252) 744-2393 to schedule your appointment today.