Transhepatic venous access for hemodialysis-single centre expirience

Abstract

Introduction. A percutaneous transhepatic approach has been used to place tunneled catheters in the inferior vena cava for hemodialysis. This route through the suprahepatic vein could be used to place a tunnelled catheter for permanent haemodialysis without complications and with an excellent permeability rate. Single centre expirience. From 2011 to 2020 in a Military Medical Academy we treated 4 patients with transhepatic central venous catheter for hemodialysis. All of them had exhausted approaches during period of hemodialysis. Arterio-venous fistulas had been thrombosed on the arms, thrombosis subclavian vein billateraly or superior cava veinand complications by femoral catheters was present. Peritoneal dialysis was not possible. Discusion. Limited number of papers descripted outcome of placement transhepatic catheters for hemodialysis. In our expirience one patient needed scroll catheter due hemodialysis had not well outcome, and one patient needed thrombolysis catheter.Two of them are on hemodialysis without complications for 300 and 1650 days. Conclusion. The transhepatic venous access under ultrasound and radioscopic guidance is a simple and safe method. It is an acceptable alternative for permanent haemodialysis catheters when other venous accesses are exhausted, and when it is performed by a well-trained team.