The novel use of the Haemodialysis reliable outflow graft (HeRo®) in intestinal failure patients with end-stage vascular access.

Dengu F., Hunter J., Vrakas G., Gilbert J.

Intestinal failure (IF) patients are dependent on central venous access to receive parenteral nutrition. Longstanding central venous catheters are associated with life-threatening complications including infections and thromboses resulting in multiple line exchanges and the development ofprogressive central venous stenosis or occlusion. The Haemodialysis Reliable Outflow (HeRO) graft is an arterio-venous device that has been successfully used in haemodialysis patients with 'end-stage vascular access'. We describe a case series of HeRO graft use in patients with IF and end-stage vascular access. Four HeRO grafts were inserted into IF patients with end-stage vascular access to facilitate or support intestinal transplantation. In all patients the HeRO facilitated immediate vascular access, supporting different combinations of parenteral nutrition, intravenous medications, fluids or renal replacement therapy with no bloodstream infections. In a highly complex group of IF patients with central venous stenosis/occlusion limiting conventional venous access or at risk of life-threatening catheter-related complications, a HeRO® graft can be a feasible alternative.

DOI

10.1177/1129729820961972

Type

Journal article

Journal

J Vasc Access

Publication Date

11/2021

Volume

22

Pages

1021 - 1025

Keywords

Hemodialysis Reliable Outflow (HeRO) graft, Prosthetic grafts, catheters dialysis access, central venous occlusion, dialysis access, intestinal transplant, nutrition, techniques and procedures, Arteriovenous Shunt, Surgical, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Catheterization, Central Venous, Central Venous Catheters, Humans, Kidney Failure, Chronic, Renal Dialysis, Treatment Outcome, Vascular Diseases, Vascular Patency

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