Life-saving vascular access after combined liver and kidney transplantation: A challenging access to the right atrium

J Vasc Access. 2019 Jul;20(4):442-445. doi: 10.1177/1129729818820516. Epub 2019 Jan 4.

Abstract

Exhaustion of vascular accesses is a major complication in patients undergoing hemodialysis, especially in pediatric setting. We report the case of a boy treated for loss of hemodialysis access after a combined liver-kidney transplantation and transient renal dysfunction. An interventional dilatation of calcific superior vena cava allowed to insert a stable central venous line for dialysis until full graft recovery. Careful management of central lines allows to spare the main vessels and reduces the need for unusual accesses.

Keywords: End-stage liver disease; children; end-stage kidney disease; hemodialysis; kidney transplantation; liver transplantation.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon*
  • Catheterization, Central Venous / methods*
  • Child
  • Delayed Graft Function / diagnosis
  • Delayed Graft Function / etiology
  • Delayed Graft Function / physiopathology
  • Delayed Graft Function / therapy*
  • Humans
  • Kidney Diseases / diagnosis
  • Kidney Diseases / etiology
  • Kidney Diseases / physiopathology
  • Kidney Diseases / therapy*
  • Kidney Diseases, Cystic / complications
  • Kidney Diseases, Cystic / diagnosis
  • Kidney Diseases, Cystic / surgery*
  • Kidney Transplantation / adverse effects*
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / surgery*
  • Liver Transplantation / adverse effects*
  • Male
  • Phlebography
  • Renal Dialysis*
  • Treatment Outcome
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / physiopathology
  • Vascular Calcification / therapy*
  • Vascular Patency
  • Vena Cava, Superior* / diagnostic imaging
  • Vena Cava, Superior* / physiopathology