Outcome of Arteriovenous Fistula Following Renal Transplantation

Abstract

Background: Renal transplantation is the preferred treatment for end-stage renal disease (ESRD), but the management of arteriovenous fistulas (AVFs) post-transplant remains controversial due to complications like thrombosis.Objective: To determine the outcome of AVFs following renal transplantation, focusing on the incidence and timing of AVF thrombosis.Methods: This ambi-directional cohort study included 155 patients with ESRD who underwent kidney transplantation at the Sindh Institute of Urology and Transplantation, Karachi, in 2021. All included patients had a functional AVF at the time of transplantation. Data were collected from electronic health records, including demographic information, AVF characteristics, and incidence of thrombosis. AVF outcomes were monitored through follow-up assessments until September 2024. Statistical analysis was conducted using SPSS version 25, with significance set at p<0.05.Results: Thrombosis occurred in 71 (45.8%) patients, most frequently within one week (14.8%), within four weeks (21.9%), and within one year (34.2%). Surgical ligation was required in 5 patients (3.22%). No significant associations were found between thrombosis and age, comorbidities, or AVF type (p>0.05).Conclusion: AVF thrombosis is a frequent complication post-transplant, not significantly influenced by patient demographics or AVF type, highlighting the need for continued surveillance.