Arteriovenous (AV) graft infection part 8

ALLOGRAFT METHOD VS GRAFT EXCISION METHOD

There are 2 methods for treating infected hemodialysis arteriovenus graft - the allograft method and the graft excision method. The graft excision method is generally used to manage a synthetic graft infection.

• The allograft method is a single procedure which involves removing the infected arteriovenous graft and implanting the cryopreserved allograft in the same infected site. Preserving the vascular access saves potential future arteriovenous access site. Access is possible 10-14 days after implantation.

• The graft excision method involves two separate procedures. First the infected arteriovenous graft is removed. After the infection has cleared, a new arteriovenous graft is placed in a different location, which diminishes potential sites for future access

A temporary central venous catheter and intravenous antibiotic therapy are needed for both methods. The duration of the central venous catheter  is generally longer for the graft excision method because a central venous catheter is needed after the first and  second procedures, until the new arteriovenous graft is ready for cannulation.