Purpose: The objective of this study was to determine the safety and functionality of cuffed transhepatic catheters as access for hemodialysis.
Methods and Materials: We performed a retrospective review of the records of 16 patients who underwent 21 separate transhepatic hemodialysis catheter accesses over a 40-month interval. Transhepatic catheters were placed either because of the absence of an available venous site (11 patients) or to preserve a single remaining venous site for placement of permanent vascular access. Technical success of catheter placement, initial and revised device service, as well as total access site service interval were evaluated. Reasons for device failure and complications were also assessed.
Results: Technical success was achieved in all patients. The mean total access site service interval was 138 catheter days with a (range 0 to 599). Of the 16 initial catheters, 5 dislodged prematurely requiring placement of a new access. 21 catheters required 30 exchanges (range 1 to 6) in 10 patients (48%). The most common reason for catheter exchange was for device failure. There were 6 complications among 21 catheter placements (29%) including one death the day following catheter placement from massive intraperitoneal hemorrhage.
Conclusion: Transhepatic cuffed dialysis catheters offer a feasible access site to patients with limited options. High maintenance and complication rates however may limit this procedure as a long-term option.
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