Background
What is Vascular Access?
When someone has kidney failure, their kidneys are unable to filter waste and excess fluids from the blood effectively. Hemodialysis is a treatment that helps clean the blood using a machine. For this treatment to work, doctors need a way to access the blood. This is where vascular access comes in.
Vascular access is how the hemodialysis machine is connected to a patient’s blood vessels. There are a few methods to create this access:
Fistula:
This is the most commonly used method and is the gold-standard for vascular access. It involves a small surgical procedure where a vein is connected to an artery in the patient’s arm. This connection makes the vein larger and stronger, making it easier to draw blood for dialysis and return it after it has been cleaned. This method leads to better long-term outcomes for patients, with lower rates of complications, but requires surgeons and nursing staff to train in the formation and long-term care of them.
Graft:
If a fistula is not suitable, surgeons may use a graft. This involves placing a synthetic tube between an artery and a vein, which allows blood to flow easily. This is a good choice for patients who are unsuitable for a fistula, but this method has higher rates of complications. Once again it requires surgeons and nursing staff to learn how to perform the procedure and manage the patients post-operatively.
Catheter:
In some cases, a tube called a catheter may be temporarily placed in a vein, commonly in the neck. This is often used for patients who need immediate dialysis or while waiting for a fistula or graft to be formed. Although these catheters can be used for a long time, they are associated with the most complications and ideally should be avoided.
Having good vascular access is crucial because it allows for effective and efficient treatment during hemodialysis sessions. Proper care of the access point is also important to prevent infections and complications. However, these services are often unavailable to the millions of patients suffering with kidney failure around the world.
What is a Kidney Transplant?
A kidney transplant is a surgical procedure that involves replacing a person’s damaged or non-working kidney with a healthy kidney from another person. This new kidney can come from a living donor (someone who donates one of their healthy kidneys) or a deceased donor (someone who has passed away but whose kidneys are still healthy).
Why Do People Need a Kidney Transplant?
People need a kidney transplant when their own kidneys are no longer functioning well enough to keep them healthy (when they develop kidney failure). Kidney failure or end-stage kidney disease, can happen due to various issues, including:
Chronic Kidney Disease:
Long-term conditions, such as diabetes or high blood pressure, can damage the kidneys over time.
Genetic Disorders:
Some inherited conditions can affect kidney function.
Acute Kidney Injury:
Sudden damage to the kidneys from infections, medications, or other illnesses can lead to kidney failure.
For many people with kidney failure, management strategies like dialysis can help, but they do not replace the natural function of the kidneys. A transplant can provide a better quality of life and normal life-expectancy for the recipient.
Around the world, access to kidney transplant can be transformative, not only for the patient, but also their family and wider social network, who are often involved in having to care and support the patient during their illness and treatment.
