POS-556 VASCULAR MORBIDITY ASSOCIATED WITH TUNNELIZED CATHETERS FOR HEMODIALYSIS IN THE POST-TRANSPLANT PERIOD

Abstract

One of the most determining factors of morbidity and mortality of hemodialysis patients is the presence of jugular vein tunnelized catheter (JTC) as vascular access (VA). Our purpose was to determine the effect of vascular complications related to JTC during HD period and their consequences after kidney transplant. We analyzed the presence of vascular complications related to JTC in 196 consecutive kidney transplant patients realized in our center during 2010-2020. 6 transplanted patients (5 males) present VA complications, mean age was 69.17±8.68 ys. CKD etiologies were diabetic nephropathy (n=4), nephroangiosclerosis (n=1) and IgAN (n=1). All of them were hypertensive and 3 had peripheral vascular disease. During their HD period, 4 patients presented complications related to JTC: dysfunction (n=3) and stenosis of subclavian vein (n=1). In 4 patients these complications occurred in the first three months after JTC implantation. Endovascular treatment performed was JTC replacement (n=3) and angioplasty (n=1). Prior to transplantation, the VA of all patients was the AVF and none had YTC.In the post-transplant, the entire sample studied presented vascular complications related to VA: stenosis of subclavian vein (n=3), secondary heart failure (n=1), partial AVF occlusion (n=1), and complete jugulo-subclavian occlusion (n=1). The 50% of the complications appeared 3 months after transplantation and the rest, from the first year. Initial treatment in all cases it was balloon angioplasty ± stent and antiplatelet therapy. In a period of less than 3 months, there was a close of 70% of relapses, thus deciding the closure of the AVF.View Large Image Figure ViewerDownload Hi-res image Download (PPT) The presence of vascular complications in transplant patients is related to JTC as vascular access during HD period. These complications could increase the morbidity and affect graft function due in part to the interventional procedures needed to solve them. We propose strategies to identify those transplant patients at risk in order to prevent these complications.