Heparin Bonded Hemodialysis e-PTFE Grafts Result in 20% Clot Free Survival Benefit

Abstract

Luminal surface heparin bonded hemodialysis e-PTFE grafts (N=83) with prolonged bioactivity retention (CBAS technology) were compared to 67 control e-PTFE grafts using Kaplan-Meier survival curve estimates. Log-rank tests were used for statistical comparisons between groups. Heparin bonded graft recipients were on average 3.5 years older (NS), and had upper arm grafts in 66% vs. 43% (p=0.003) compared to controls. There was no clot-free survival (CFS) difference between groups for upper arm vs. forearm placed grafts (p=0.792). Patient mortality at one year was 15%, with no group difference. The overall combined clot-free survival for all 150 e-PTFE grafts was 69% at 12 months. At 6 and 12 months, CFS for the heparin bonded graft group was 88% and 78%, which is significantly higher than that of 69% and 58% for the control group, respectively, (p=0.007). It is concluded that heparin binding technology to artificial surfaces has evolved to a clinically powerful technique for the hemodialysis patient resulting in a 20% improved primary graft patency of about 80% at one year.