Mohaideen A H, Mendivil J, Avram M M, Mainzer R A
Ann Surg. 1977 Nov;186(5):643-50. doi: 10.1097/00000658-197711000-00017.
Forty-seven patients with chronic renal failure presenting with a loss of vascular access precluding hemodialysis were subjected to 105 surgical procedures to establish and to maintain an arteriovenous fistulae. 67 bovine heterografts were implanted over a 30 month period and observed for 6 or more months. Fifteen, or 32% of the patients, died during the study period. Eleven patients died with a functional fistula. Twenty fistulae continued to function at the end of 36 months constituting a 46.3% graft survival rate. Hemodialysis was continued in 11 of 12 patients via a P.T.F.E. Goretex graft or via a matured Brescia Fistula. The remaining patient experienced graft failure at the end of the study period. Graft thrombosis was observed in 31 of 67 grafts placed (46%). Successful thrombectomy was achieved in 52%. Fourteen grafts developed frank aneurysms with overt rupture in 8. All patients with aneurysms were negro. Six of 8 patients with aneurysm presented with severe hypertension. Thirteen aneurysms were resected without loss of life or limb. The use of bovine grafts in hypertensive negro patients is believed to be contraindicated.
47例慢性肾衰竭患者因血管通路丧失无法进行血液透析，接受了105次建立和维持动静脉内瘘的外科手术。在30个月的时间里植入了67个牛异种移植物，并观察了6个月或更长时间。15例患者（占32%）在研究期间死亡。11例患者死于有功能的内瘘。20个内瘘在36个月结束时仍在发挥功能，移植物存活率为46.3%。12例患者中的11例通过聚四氟乙烯（P.T.F.E.）戈尔特斯移植物或成熟的布雷西亚内瘘继续进行血液透析。其余患者在研究期结束时移植物失败。在所植入的67个移植物中，有31个观察到移植物血栓形成（46%）。52%的患者成功进行了血栓切除术。14个移植物形成了明显的动脉瘤，其中8个发生了明显破裂。所有有动脉瘤的患者均为黑人。8例有动脉瘤的患者中有6例患有严重高血压。13个动脉瘤被切除，未造成生命或肢体损失。在高血压黑人患者中使用牛移植物被认为是禁忌的。
