Report on blood access for hemodialysis in the Department of Transplantation, Tokai University School of Medicine and a satellite hospital.

There were 316 patients being treated by maintenance hemodialysis in the Department of Transplantation, Tokai University School of Medicine and its satellite hospital (Bohsei Clinic, Medical Treatment Cooperation, Showakai) as of December 31, 1981. Forty eight male (23.1%) and 39 female (35.7%) patients were operated on for external shunts. One case of external shunt was functioning well 48 months later. No patient was dialysed through external shunts on December 31, 1981 in our Department or the satellite. The majority of patients, who were maintained on hemodialysis with an arteriovenous (native vein) fistula available, experienced no difficulties. Nearly 50 percent of cases with the first fistula were functioning on December 31, 1981. There were some complications with fistulas such as pseudoaneurysms, infections, the sore thumb syndrome or the steal syndrome. We experienced 14 hemodialysis cases using expanded polytetrafluoroethylene (E-PTFE) grafts and one case using femoral artery repositioning as blood access.