Umbilical cord vein fistula for vascular access in hemodialysis.

Human umbilical cord vein allografts (HUCVAG) were modified by sequential treatment with 95% ethanol and 1.3% dialdehyde starch and stored in 70% ethanol. Tensile strength measurements of HUCVAG were found to range between canine aorta and bovine heterograft. Surface clotting was prolonged to 4 times that of pre-clotted dacron velour and 2 times that of bovine carotid heterograft. Inferior vena cava implants of HUCVAG remained patent for a period of 10 to 14 days while 4 of 5 bovine carotid heterografts clotted in 2 hrs ans one within 3 days. Micrpscopic examination showed a smooth intimal surface with no fibrin deposition and no evidence of rejection, providing excellent basic qualities as a vascular substitute. Using "14 gauge cannula, 180 repetitive percutaneous punctures were made in 10 heparinized dogs with HUCVAG fistulas between the carotid artery and external jugular vein. With exception of one instance in any preparation over a 4 month period. These results suggest the valueless. unbranched modified umbilical cord vein in unlimited supply is suitable as an arteriovenous fistula for blood access in maintenance hemodialysis.