A dialysis graft is an artificial vein a doctor can implant under a patient's skin to provide regular vascular access for dialysis. This is necessary for a patient who needs dialysis treatments into the foreseeable future, as the procedures require regularly inserting needles into the blood vessels to collect, scrub, and return blood. The dialysis technician can quickly work through the available blood vessels and have no way to access the patient's circulatory system for future hemodialysis sessions.
The preferred method for vascular access is actually a hemodialysis fistula, where a surgeon joins an artery to a vein, typically in the arm. The vein enlarges and strengthens, making it easier to access, and the blood flows readily through the area. Risks of infection, rejection, and clotting are low because the fistula contains no foreign materials. If a fistula is not an option, the surgeon can consider a dialysis graft, where a short length of synthetic tubing or a blood vessel from an animal is used to create access.
Risks of a dialysis graft can include infection and clotting. The graft may only last a few years before replacement becomes necessary, even with periodic procedures to clean it out, break up clots, and address the narrowing of blood vessels around the graft. The advantage is that a dialysis graft takes much less time to heal than a fistula, and is often ready to use safely within weeks.
If a doctor thinks a patient is a good candidate for a dialysis graft, a vascular surgeon will usually perform the procedure. Special care is taken to limit infection, and the graft goes in the patient's non-dominant arm, either on the underside of the arm or the hand. The patient needs to keep the area clean after surgery, and may take prophylactic antibiotics to prevent infections. Once the graft is totally healed, a hemodialysis technician can start to use it in the patient's dialysis sessions.
The surgeon may want to periodically evaluate the graft for signs of problems like clots. If an issue develops, the patient will need to come in for an outpatient procedure to clean the dialysis graft, bust any clots present in the length of tubing, and address any other issues. The nature of the procedure will vary depending on what the problem is, and patients can get more information about what to expect from their doctors when they are preparing for treatment.
