Iliac Artery-Iliac Vein Human Umbilical Cord Vein Graft for Hemodialysis in Patients with Exhausted Access Sites

Abstract

A patient who had undergone chronic hemodialysis for renal failure was evaluated for hemodialysis access failure. At the time of his initial examina tion, all available veins and arteries in the patient's arms and legs had been compromised by placement of arteriovenous fistulas or shunts, and he was being maintained with peritoneal dialysis. By means of a previously unreported technique, a human umbilical vein graft was interposed between the iliac artery and the iliac vein. The external iliac artery was extremely diseased, but pulsation and flow seemed adequate. Postoperatively, there was no evidence of lower extremity ischemia or venous hypertension. After 8 days of peritoneal dialysis, the graft was cannulated in the usual fashion for hemodialysis. However, due to the severe aortoiliac disease, flows were less than desirable, and the patient died.