IMMEDIATE POSTOPERATIVE COMPLICATIONS FOLLOWING HEMODIALYSIS ACCESS PROCEDURES

From August 1989 to August 1994, 173 arteriovenous fistulas were const ructed in 162 patients for permanent hemodialysis: 49 autogenous and 1 24 graft fistulas (polytetraflouroethylene (PTFE)-119, others-5), Prev ious access procedures were noted in 93 graft fistulas (76%) versus 8 autogenous fistulas (16.3%), In the immediate postoperative period, 13 graft fistulas (10.6%) developed complications (5 anastomotic hemorrh ages, 4 thrombosis, 3 hypotension without hemorrhage, and 1 sepsis), w hile 2 (4.1%) autogenous fistulas developed immediate postoperative co mplications (1 anastomotic hemorrhage and 1 thrombosis). Graft fistula s had a higher, although not statistically significant incidence of im mediate postoperative complications versus autogenous fistulas. These graft fistula complications were associated with multiple access proce dures and required surgical exploration, Based on these results, we sh ould make every effort to construct the autogenous fistula as the firs t choice of hemodialysis access procedure in properly selected patient s.