Retrospective analysis of the effect of arteriovenous fistula on graft functions in kidney transplant recipients

Nowadays, there is still a debate about the necessity of an arteriovenous (A-V) fistula to remain open after a successful kidney transplant. The aim of this retrospective study was to evaluate the effects of A-V fistulas on the clinical outcome and graft function in transplant recipients. A total of 247 patients underwent kidney transplantation in our center were included in the study. The patients were divided into two groups as nonAVF and AVF. The patients with A-V fistula were then subdivided into three subgroups: Subjects with fistula closed spontaneously (AVFs), remained open (AVFp) and closed surgically (AVFc) after transplantation. The characteristics of the patients were compared. The age of the patients in the AVF group was higher than in the nonAVF group. In 40 patients with A-V fistula, the fistula was surgically closed after transplantation. Fistula was closed due to cardiac complaints in 14 patients, edema in 8 patients and infection in 6 patients. The median transplant durations of the AVFs and AVFc groups were higher than those of the AVFp group. The frequency of hypertension in the AVFs group was higher than in the AVF group. The most common symptoms associated with A-V fistula were exercise dyspnea, tachycardia and hypertension after transplantation. The most common findings were thrill, peripheral pulse palpation in A-V fistula arm and pulsation. The median flow rates in the AVFp and AVFc groups were higher than in the AVFs group. The rate of left ventricular hypertrophy in the AVFc group was higher than in the AVFs group. The incidence of hypertension in the AVFs group was higher than in the AVF group. The hemoglobin level was higher in the AVF group. The presence of proteinuria in the AVFs group was higher than in the AVF group. There were no significant differences in serum creatinine and GFR measurements between the AVF and non-AVF groups and between the three groups with open A-V fistula. Dialysis and mortality rates were similar in nonAVF and AVF groups. In conclusion, we did not observe a negative effect of A-V fistula presence on graft function. Key words: kidney transplantation, arteriovenous fistula, graft function, graft survival, cardiovascular complication.