Arteriovenous fistula after kidney transplantation in Clinical Hospital Centre Osijek

CILJ: Istražiti udio ispitanika u kojih je nakon bubrežnog presađivanja (transplantacije, TX) došlo do tromboze ili ligacije arterijskovenske fistule (AVF) te istražiti vrijeme nakon TX-a u kojemu je došlo do gubitka funkcije AVF-a. NACRT ISTRAŽIVANJA: Istraživanje je ustrojeno kao kohortno povijesno istraživanje. ISPITANICI I POSTUPCI: Uključeno je svih 123 bolesnika (57,7 % muških, medijana dobi 58 godina, od 34 do 79) kojima je bubrežni presadak transplantiran u Kliničkom bolničkom centru Osijek tijekom prvih 10 godina otkako se u toj bolnici vrši bubrežni TX. Iz medicinskih zapisa preuzeti su podaci o funkciji AVF-a, trombozama i ligacijama, kao i demografski podatci (dob, spol, vrijeme nakon TX-a). Podaci su prikazani deskriptivno i analitički, a statistički obrađeni pomoću SPSS-a (inačica 17.0). REZULTATI: AVF neposredno prije TX-a imalo je 78 % bolesnika. Još uvijek funkcionira u 39,84 % svih ispitanika, 3 godine (medijan, interkvartilni raspon, IQR od 0 do 3) nakon TX-a. Tromboza AVF-a je nastupila u njih 17,89 %, a ligacija je izvedena u 20,33 % svih ispitanika. Najčešći razlog ligacije AVF-a u našem istraživanju bio je srčano opterećenje (u 75 % ligacija), zatim aneurizmatična dilatacija AVF-a te otok ruke. Vrijeme nakon TX-a do tromboze ili ligacije bilo je medijana 2 godine (IQR 0 – 3). Tromboza ili ligacija bili su značajno češći u žena. Sudbina AVF-a nakon bubrežnog TX-a nije bila povezana s dobi bolesnika. .ZAKLJUČAK: AVF nakon bubrežnog TX-a često postaje nefunkcionalna, nakon spontane tromboze ili kirurške ligacije, a koja je najčešće indicirana zbog srčanog opterećenja.AIMS: To examine the proportion of patients with thrombosis or surgical ligation of arteriovenous fistula (AVF) after kidney transplantation (TX) and to explore the time passed after the TX until the loss of AVF function. DESIGN: The study design was historical cohort study. PATIENTS AND METHODS: The study included all 123 patients (57.7 % men, median age 58 years, from 34 to 79) that underwent kidney TX in University Hospital Centre Osijek during the first 10 years of practicing that kind of surgery in the hospital. The data on AVF function, thrombosis or ligation were undertaken from medical records, along with demographics (age, gender, time after TX). The data were presented descriptively and after statistical analysis that was performed using SPSS (version 17.0). RESULTS: Functional AVF immediately prior to TX was found in 78 % of the patients. The AVF was still functional in 39.84 % of all patients for 3 years (median, interquartile range, IQR 0 – 3) after TX. AVF thrombosis happened in 17.89 %, while surgical ligation was performed in 20.33 % of all patients. The most common reason for ligation was increased risk of heart failure (in 75 % of the ligations), followed by aneurysmatic dilatation and arm swelling. Median time after TX to thrombosis or ligation of AVF was 2 years, IQR 0 – 3. Thrombosis or ligations were significantly more frequent in women. The outcome of AVF after kidney TX was not related to the patient’s age. CONCLUSION: AVF after kidney TX often became nonfunctional, either after spontaneous thrombosis or after surgical ligation, which was required for increased heart failure risk in the majority of the cases